tci Medicare Compliance & Reimbursement - 2012 Issue 18
Industry Notes: CMS Issues New 'Centralized Flu' NPP Specialty Code
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Article Overview
This article summarizes several CMS and Medicare policy developments affecting providers, suppliers, and hospice organizations. It covers a new CMS enrollment specialty designation, a prepayment audit demonstration, planning for skilled nursing facility value-based purchasing, a new durable medical equipment competitive bidding round, a hospice appeal court decision, and a hospice documentation review focus. The piece is useful for compliance, reimbursement, enrollment, and operational teams tracking Medicare program changes.
Why This Topic Matters
The article brings together multiple Medicare administrative and payment-policy updates that can affect enrollment, claims review, reimbursement strategy, supplier bidding, and hospice compliance workflows. It helps readers quickly gauge whether the full article is relevant to their CMS, Medicare, or hospice-related responsibilities.
Article Sections
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CMS Announces New Specialty Code
Covers a new CMS enrollment specialty designation and where it applies within Medicare enrollment processes.
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Will CMS Implement Pre-Pay Audits in Your State?
Summarizes a Medicare Recovery Audit prepayment review demonstration, including the states involved and the broader program context.
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Get Ready: CMS Plans to Move Medicare SNF Payments from Volume to Value-based
Reviews CMS planning for skilled nursing facility value-based purchasing and the topics addressed in the report to Congress.
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New Round Of DME Bidding Launched
Covers the opening of a Medicare competitive bidding round for durable medical equipment and the general categories included.
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Court Case Spotlights How Hospice Patients Can Appeal Denials
Discusses a hospice appeals court decision and its implications for beneficiary appeal rights and hospice coverage disputes.
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Avoid These Diagnoses On Your Hospice Claims To Quell Denials
Summarizes a hospice claim review focus involving documentation and denial issues identified by a Medicare contractor.
What You Will Learn
- How CMS policy and administrative updates are affecting multiple Medicare program areas
- What broad types of enrollment, audit, payment, bidding, and hospice topics are addressed
- Which provider and supplier groups are most likely to be interested in the article
- What general compliance and operational issues are highlighted across the roundup
Who Should Read This
- Medicare providers
- Hospice organizations
- Durable medical equipment suppliers
- Skilled nursing facilities
- Revenue cycle and compliance professionals
- Medical coders and billing staff
Codes Discussed
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