Blog

  • Posted on November 5, 2012

    Medicare Part B Outpatient Therapy Cap and Exceptions Process 


    The Middle Class Tax Relief and Job Creation Act of 2012 (H.R. 3630) was signed into law on February 22, 2012. The law extends the Medicare Part B Outpatient Therapy Cap Exceptions Process through December 31, 2012. 


    Background
    The statutory Medicare Part B outpatient therapy cap for Occupational Therapy (OT) is $1,880 for 2012, and the combined cap for Physical Therapy (PT) and SpeechLanguage Pathology Services (SLP) is also $1,880 for 2012. This is an annual per beneficiary therapy cap amount determined for each calendar year.  Medicare allowable charges,which includes both Medicare...

  • Posted on June 1, 2012

    In accordance with the Affordable Care Act, readmissions to the hospital are being scrutinized by CMS . Hospitals will face penalties for readmissions for three preventable conditions: acute myocardial infarction, pneumonia, and heart failure. The Affordable Care Act created the Hospital Readmission Reduction Program, also known as HRRP, which will be implemented with hospital discharges on/after October 1, 2012. Readmission is defined as discharge from a hospital to a non-acute setting following by admission to the same or another hospital within 30 days of that discharge for any reason. CMS has been monitoring hospital readmissions for some time now but as of October 1st, payments to hospitals will be tied to performance measures....

  • Posted on May 10, 2012

    From the CMS ListServ today:

    "CMS is aware of a systems problem that is delaying payment of some inpatient and Skilled Nursing Facility claims processed beginning April 2. The systems issue has been fixed and payments for these claims will be made soon. Providers that believe their claims have been delayed should check the claims status after May 15. CMS apologizes for the inconvenience."

  • Posted on March 28, 2012

    The Answers Spring 2012 version was released this month. In order to help you prepare for this release we have published a series of videos to help you get the most out of the latest features in the system. These videos are available to you at www.AODsoftware.com/spring2012videos

    Additionally, CMS has issued new guidelines for the MDS 3.0 that take effect on April 1st. We have also published a video that discusses these guidelines in detail:

    Click here to access the MDS 3.0 Update...