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Separate benefit for complex rehab: Let the discussions begin |
By Liz Beaulieu Editor - 03.05.2010
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BUFFALO, N.Y. - When industry stakeholders gave an overview of a "discussion paper" that details a separate benefit for complex rehab during a Webinar last week, providers and therapists had a lot of questions. That's exactly the response stakeholders were hoping for.
"We've labeled it a discussion paper for a specific reason," said Don Clayback, executive director of NCART and chairman of a steering committee working to create the benefit. "It's meant for discussion. It's not a final plan; it's not a finished product; it's not something that's take-it-or-leave-it. It's meant to be circulated to allow people to respond."
The 24-page paper has been posted to NCART's Web site, www.ncart.us. It proposes changes to products and coding; coverage and documentation; payment; and supplier quality standards.
Highlights from the Webinar:
Products and coding
Current HCPCS codes, where appropriate, would be classified as complex rehab technology (CRT) and would be available only through accredited CRT companies; modifications would be made, as needed, to codes that currently contain both CRT products and non-CRT products to separate CRT from DME; and new codes would be added for CRT products that are routinely provided but currently don't have assigned codes.
"At the end of the day, there should be a fairly bright line," said Rita Hostak, vice president of government relations for Sunrise Medical and a member of the steering committee. "One line says, 'yup, this is clearly DME,' and one says, 'yup, this is complex rehab technology.'"
Coverage and determination
Coverage criteria would be based on a beneficiary's functional abilities and limitations, not specific diagnoses; the burden of clinical documentation would be shifted to the therapist's shoulders instead of the physician's; and the "in-the-home" restriction would be eliminated.
Payment
A payment methodology would be established that covers both the product costs and related service costs that are associated with CRT products. Avalere Health Group will help to determine the potential options and preferred methodology.
Supplier quality standards
Complex rehab technology companies would be required to offer service and repairs to beneficiaries in their sales area, either through their own operations or through another accredited company. For beneficiaries outside their sales area, they would have to make their best effort to locate another accredited company.
Also, the companies would be required to have at least one rehab technology professional (RTP) on staff. An RTP is an individual who has passed RESNA's ATP exam and has fulfilled "additional requirements." Those requirements may include obtaining RESNA's seating and mobility specialist (SMS) certification or an enhanced version of NRRTS's CRTS credential.
Stakeholders pointed out that work on these areas will continue through various working groups.
Questions were largely detail-oriented. For example: In rural areas where there are no seating clinics and few therapists, how would providers comply with the benefit?
"We realize the ideal situation may not be achievable in every instance, but we won't let that dissuade us from getting there, or as close as we can," Clayback said.
Stakeholders plan to collect feedback on the paper all of March. Providers and therapists can do that two ways: e-mail comments to complexrehabtech@gmail.com or post comments to a new blog, http://complexrehabtech.blogspot.com.
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HME News Info Center |
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| 8-8 They’re Auditing Me! What Do I Do Now? | Attendance is $99
During this event, Andrea Stark will walk you through the entire audit process step-by-step, from the moment you receive a request for additional documentation, through the time you submit your initial response and (if necessary) your appeal. Most importantly, Andrea will ensure you gain a clear understanding of your full rights while undergoing an audit.
For more information or to register, visit: http://www.miravistallc.com/recent_services.php.
| | 13-13 “Contracting Time is Here: Do You Know Your Game Plan?” | In Cincinnati on July 13.
While the DME provider community continues to work strenuously to repeal the competitive bidding program, the VGM National Competitive Bidding Services team is hitting the road again. Throughout July and August, the group will be co-hosting, along with respective state associations, full-day seminars, “Contracting Time is Here: Do You Know Your Game Plan?” The series will be presented by Mark Higley, vice president-development; John Gallagher, vice president-government relations; Alan Morris, regulatory analyst, all from VGM; and attorney Neil Caesar, president, Health Law Center. The series, designed for all providers affected by the bidding program, will focus on:
· Detailed overview of the contractual obligations for bid winners.
· Discussion about financially evaluating a bidding contract, including a take-home comprehensive Contract Evaluation Toolkit.
· Legal advice and legal document templates for subcontracting and change of ownership.
· Dos, don’ts, and tips on marketing your competitive bidding contract or subcontracting agreement.
· In-depth legislative update on activity on Capitol Hill related to the effort to repeal competitive bidding, as well as other DME industry issues.
| | 13-13 Pre-Payment Reviews and RAC Audits | “Pre-Payment Reviews and RAC Audits: Steps to Prepare for and Survive These Life-Altering Events," presented by Jeffrey Baird, Esq., Brown & Fortunato, P.C. Call AAHomecare for details: 703.836.6263.
| | 14-14 “Contracting Time is Here: Do You Know Your Game Plan?” | In Pittsburgh on July 14.
While the DME provider community continues to work strenuously to repeal the competitive bidding program, the VGM National Competitive Bidding Services team is hitting the road again. Throughout July and August, the group will be co-hosting, along with respective state associations, full-day seminars, “Contracting Time is Here: Do You Know Your Game Plan?” The series will be presented by Mark Higley, vice president-development; John Gallagher, vice president-government relations; Alan Morris, regulatory analyst, all from VGM; and attorney Neil Caesar, president, Health Law Center. The series, designed for all providers affected by the bidding program, will focus on:
· Detailed overview of the contractual obligations for bid winners.
· Discussion about financially evaluating a bidding contract, including a take-home comprehensive Contract Evaluation Toolkit.
· Legal advice and legal document templates for subcontracting and change of ownership.
· Dos, don’ts, and tips on marketing your competitive bidding contract or subcontracting agreement.
· In-depth legislative update on activity on Capitol Hill related to the effort to repeal competitive bidding, as well as other DME industry issues.
| | 15-15 “Contracting Time is Here: Do You Know Your Game Plan?” | In Orlando July 15.
While the DME provider community continues to work strenuously to repeal the competitive bidding program, the VGM National Competitive Bidding Services team is hitting the road again. Throughout July and August, the group will be co-hosting, along with respective state associations, full-day seminars, “Contracting Time is Here: Do You Know Your Game Plan?” The series will be presented by Mark Higley, vice president-development; John Gallagher, vice president-government relations; Alan Morris, regulatory analyst, all from VGM; and attorney Neil Caesar, president, Health Law Center. The series, designed for all providers affected by the bidding program, will focus on:
· Detailed overview of the contractual obligations for bid winners.
· Discussion about financially evaluating a bidding contract, including a take-home comprehensive Contract Evaluation Toolkit.
· Legal advice and legal document templates for subcontracting and change of ownership.
· Dos, don’ts, and tips on marketing your competitive bidding contract or subcontracting agreement.
· In-depth legislative update on activity on Capitol Hill related to the effort to repeal competitive bidding, as well as other DME industry issues.
| | 20-20 "Contracting Time is Here: Do You Know Your Game Plan?" | In Dallas on July 20.
While the DME provider community continues to work strenuously to repeal the competitive bidding program, the VGM National Competitive Bidding Services team is hitting the road again. Throughout July and August, the group will be co-hosting, along with respective state associations, full-day seminars, “Contracting Time is Here: Do You Know Your Game Plan?” The series will be presented by Mark Higley, vice president-development; John Gallagher, vice president-government relations; Alan Morris, regulatory analyst, all from VGM; and attorney Neil Caesar, president, Health Law Center. The series, designed for all providers affected by the bidding program, will focus on:
· Detailed overview of the contractual obligations for bid winners.
· Discussion about financially evaluating a bidding contract, including a take-home comprehensive Contract Evaluation Toolkit.
· Legal advice and legal document templates for subcontracting and change of ownership.
· Dos, don’ts, and tips on marketing your competitive bidding contract or subcontracting agreement.
· In-depth legislative update on activity on Capitol Hill related to the effort to repeal competitive bidding, as well as other DME industry issues.
| | 20-20 Audits…a Four Letter Word | “Audits…a Four Letter Word: How to Prepare for and Respond to DME MAC and ZPIC Audits,” presented by Jeffrey Baird, Esq., Brown & Fortunato, P.C. Call AAHomecare for more details: 703.836.6263.
| | 21-21 "Contracting Time is Here: Do You Know Your Game Plan?" | In Kansas City July 21.
While the DME provider community continues to work strenuously to repeal the competitive bidding program, the VGM National Competitive Bidding Services team is hitting the road again. Throughout July and August, the group will be co-hosting, along with respective state associations, full-day seminars, “Contracting Time is Here: Do You Know Your Game Plan?” The series will be presented by Mark Higley, vice president-development; John Gallagher, vice president-government relations; Alan Morris, regulatory analyst, all from VGM; and attorney Neil Caesar, president, Health Law Center. The series, designed for all providers affected by the bidding program, will focus on:
· Detailed overview of the contractual obligations for bid winners.
· Discussion about financially evaluating a bidding contract, including a take-home comprehensive Contract Evaluation Toolkit.
· Legal advice and legal document templates for subcontracting and change of ownership.
· Dos, don’ts, and tips on marketing your competitive bidding contract or subcontracting agreement.
· In-depth legislative update on activity on Capitol Hill related to the effort to repeal competitive bidding, as well as other DME industry issues.
| | 22-22 "Contracting Time is Here: Do You Know Your Game Plan?" | In Charlotte, N.C., July 22
While the DME provider community continues to work strenuously to repeal the competitive bidding program, the VGM National Competitive Bidding Services team is hitting the road again. Throughout July and August, the group will be co-hosting, along with respective state associations, full-day seminars, “Contracting Time is Here: Do You Know Your Game Plan?” The series will be presented by Mark Higley, vice president-development; John Gallagher, vice president-government relations; Alan Morris, regulatory analyst, all from VGM; and attorney Neil Caesar, president, Health Law Center. The series, designed for all providers affected by the bidding program, will focus on:
· Detailed overview of the contractual obligations for bid winners.
· Discussion about financially evaluating a bidding contract, including a take-home comprehensive Contract Evaluation Toolkit.
· Legal advice and legal document templates for subcontracting and change of ownership.
· Dos, don’ts, and tips on marketing your competitive bidding contract or subcontracting agreement.
· In-depth legislative update on activity on Capitol Hill related to the effort to repeal competitive bidding, as well as other DME industry issues.
| | 29-29 "Contracting Time is Here: Do You Know Your Game Plan?" | In Miami on July 29.
While the DME provider community continues to work strenuously to repeal the competitive bidding program, the VGM National Competitive Bidding Services team is hitting the road again. Throughout July and August, the group will be co-hosting, along with respective state associations, full-day seminars, “Contracting Time is Here: Do You Know Your Game Plan?” The series will be presented by Mark Higley, vice president-development; John Gallagher, vice president-government relations; Alan Morris, regulatory analyst, all from VGM; and attorney Neil Caesar, president, Health Law Center. The series, designed for all providers affected by the bidding program, will focus on:
· Detailed overview of the contractual obligations for bid winners.
· Discussion about financially evaluating a bidding contract, including a take-home comprehensive Contract Evaluation Toolkit.
· Legal advice and legal document templates for subcontracting and change of ownership.
· Dos, don’ts, and tips on marketing your competitive bidding contract or subcontracting agreement.
· In-depth legislative update on activity on Capitol Hill related to the effort to repeal competitive bidding, as well as other DME industry issues.
| | 29-29 Have PECOS Questions? Get Straight Answers, Live! | July 29, 2010 @ 2:00pm EST
Due to the increasing number of inquiries MiraVista is receiving regarding the July 6 PECOS physician enrollment deadline and January 3, 2011 rejection implementation date, we have decided to hold this timely PECOS webinar. The majority of the webinar will be held as an open forum for suppliers to ask and receive answers to their PECOS questions directly from DME consultant Andrea Stark.
Cost is $99. Register at: http://www.miravistallc.com/recent_services.php.
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| 9-9 DMEPOS Billing Workshop: Maintaining Compliance with the Medicare Program | August 9, 2010 – Columbia, SC – 9am-5pm EST
Whether you’re looking to reduce the number of audits you are receiving or need to stay up to date on current documentation requirements for various DME, this DMEPOS billing workshop is for you! Both seasoned billers and new trainees will benefit from this course, as Andrea Stark lays the foundation for continued compliance with the Medicare program, and provides updates on recent policy changes and claims edits.
Cost is $295 for the first attendee, $225 each additional. Register at: http://www.miravistallc.com/recent_services.php.
| | 10-10 "Contracting Time is Here: Do You Know Your Game Plan?" | In Cleveland on Aug. 10.
While the DME provider community continues to work strenuously to repeal the competitive bidding program, the VGM National Competitive Bidding Services team is hitting the road again. Throughout July and August, the group will be co-hosting, along with respective state associations, full-day seminars, “Contracting Time is Here: Do You Know Your Game Plan?” The series will be presented by Mark Higley, vice president-development; John Gallagher, vice president-government relations; Alan Morris, regulatory analyst, all from VGM; and attorney Neil Caesar, president, Health Law Center. The series, designed for all providers affected by the bidding program, will focus on:
· Detailed overview of the contractual obligations for bid winners.
· Discussion about financially evaluating a bidding contract, including a take-home comprehensive Contract Evaluation Toolkit.
· Legal advice and legal document templates for subcontracting and change of ownership.
· Dos, don’ts, and tips on marketing your competitive bidding contract or subcontracting agreement.
· In-depth legislative update on activity on Capitol Hill related to the effort to repeal competitive bidding, as well as other DME industry issues.
| | 17-17 "Contracting Time is Here: Do You Know Your Game Plan?" | In Riverside, Calif., on Aug. 17.
While the DME provider community continues to work strenuously to repeal the competitive bidding program, the VGM National Competitive Bidding Services team is hitting the road again. Throughout July and August, the group will be co-hosting, along with respective state associations, full-day seminars, “Contracting Time is Here: Do You Know Your Game Plan?” The series will be presented by Mark Higley, vice president-development; John Gallagher, vice president-government relations; Alan Morris, regulatory analyst, all from VGM; and attorney Neil Caesar, president, Health Law Center. The series, designed for all providers affected by the bidding program, will focus on:
· Detailed overview of the contractual obligations for bid winners.
· Discussion about financially evaluating a bidding contract, including a take-home comprehensive Contract Evaluation Toolkit.
· Legal advice and legal document templates for subcontracting and change of ownership.
· Dos, don’ts, and tips on marketing your competitive bidding contract or subcontracting agreement.
· In-depth legislative update on activity on Capitol Hill related to the effort to repeal competitive bidding, as well as other DME industry issues.
| | 19-19 Revisiting Patient Pay: Are you leaving $ on the table? | August 19, 2020 @ 2:00pm EST
Your front-end could be the reason patient AR is ballooning. Join Andrea Stark for this informative webinar and ensure you’re taking advantage of every opportunity to proactively secure payments and reduce future collection efforts.
Cost is $49. Register at: http://www.miravistallc.com/recent_services.php
| | 31-31 MESA Fall Conference 2010 | Aug. 31-Sept. 3 in Dallas. Wondering what the future holds for DME? For your company? Obviously, no one knows ... but we all hope for the best ... and the best idea is to be prepared. MESA's Fall Conference 2010, is sure to be a comprehensive, education- and information-packed event for the HME/DME provider and staff ... and an excellent way to get prepared for your company's future in the HME industry! FMI: http://www.mesanet.org/index.php?cid=5282&src=gendocs&ref=Fall_Conference_2010_Index&category=Conferences&curlid=495
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| 2-2 Can You Really Do That? Debunking Medicare Myths | September 2, 2010 @ 2:00pm EST
This webinar will set out to distinguish the difference between Medicare myths and reality. Participants will learn what is really acceptable under Medicare guidelines and will have the opportunity to get their own Medicare myths debunked.
Cost is $99. Register at: http://www.miravistallc.com/recent_services.php
| | 12-14 2010 HME News Business Summit | Data and Market Intelligence You Can’t Get Anywhere Else!
The tools and strategies you need to drive revenue and cut costs are at the 2010 HME News Business Summit. We deliver real-life case studies, original research and industry benchmarks. Join your peers for two days of top-notch education and networking.
Nashville Hilton Downtown
Nashville, Tenn.
To review the educational program: http://www.hmesummit.com/speakers.html
To register: https://www.b2bmediaportal.com/hmesummit/hmesummit.aspx
| | 13-17 Blue Ridge Symposium | Four conferences in one week. Choose your specialty or area of interest: Sleep Conference; Asthma Education;Home Care Conference; Respiratory Care Conference
Earn at least six CRCE/CEUs everyday
Location: Blue Ridge Shadows, Front Royal, Va.
Visit us on the Web at: www.valleyhealthlink.com/brs
Contact us at: brs@valleyhealthlink.com
or Call (540) 536-8941
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| 6-7 JAMES 2010 Annual Conference | This year's theme: "Barriers to Boomers - How to Overcome and Prosper." The conference will be held at the Ocean Place Resort & Spa in Long Branch, N.J. FMI: www.jamesofnj.org.
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| 16-18 Medtrade | Georgia World Congress Center in Atlanta.
Medtrade connects the HME industry. Stay ahead of HME industry changes and find the latest tools to help your clients. Join us at the largest home medical equipment even in the western US as we bring more exhibitors, more ideas, and more products than ever before.
Visit www.medtrade.com for more information and to register.
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