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CMS Permits Initials On Amended & Delayed Entries

CMS has issued Change Request (CR) 9332, which clarifies that amendments and delayed entities into medical documentation may be initialed and dated rather than signed and dated, which had been CMS’ policy.

Upon review, a provider may occasionally discover that certain entries into the medical record at the time of service were not properly documented and need to be amended, corrected, or entered after rendering the service.

The CR instructs Medicare contractors to accept confirmation of amendments or delayed entries to paper records that are initialed and dated, if the medical record contains evidence associating the provider’s initials with their name.

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New Medicare Utilization & Payment Data Available For Medical Equipment, Supplies

As part of the Administration’s efforts to make healthcare more transparent, affordable, and accountable, CMS has posted a new data set as part of the Provider Utilization and Payment files. This data set, called Referring Provider Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Public Use File (PUF), provides information healthcare professionals who referred DMEPOS products and services, such as wheelchairs, walkers, and diabetes supplies for Medicare beneficiaries.

“The data set made available today is part of a wider set of initiatives by the Administration to achieve better care, smarter spending, and healthier people throughout our health care system,” said Acting CMS Administrator Andrew Slavitt. “CMS is providing this data to support insight and innovations in health care delivery.”

The Referring Provider DMEPOS PUF contains information on utilization, payment (allowed amount and Medicare payment), and submitted charges organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code and supplier rental indicator. This PUF was created from CMS administrative claims data for Medicare beneficiaries enrolled in the fee-for-service program available from the CMS Chronic Condition Data Warehouse.

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Home Health F2F Documentation Requirement Update

NAHC is continuing its efforts to advance legislation in Congress to reform the Medicare home health face-to-face (F2F) documentation requirement. Both the U.S. House and Senate are pursuing bicameral, bipartisan legislation that reforms the F2F requirement in order to address the burdensome paperwork requirements and the problems that have resulted for Medicare providers and beneficiaries.

NAHC is working with Congress to support the advancement of legislation that will refine bills so that they adequately address the paperwork burdens and the problems that have resulted, including wrongfully denied claims. Lawmakers intend to coordinate their legislation efforts in order to ensure they are bicameral, as well as bipartisan.

NAHC has stated that full-scale reform should:

  • Limit the physician documentation requirement to demonstrating that a timely encounter occurred, consistent with the original intent;
  • Narrow the circumstances where a face-to-face encounter is required by excluding patients transferred from a hospital or skilled nursing facility where physician encounters are virtually guaranteed;
  • Address the thousands of past claim denials by requiring the Centers for Medicare & Medicaid Services to either reach a settlement with affected home health agencies or reopen and pay those claims denied related to the physician narrative;
  • Provide an exception in areas where physicians are scarce;
  • Permit a waiver in a case-specific situation where a face-to-face encounter is not feasible; and
  • Permit face-to-face encounters by way of an expanded telehealth definition as the standard in the current law is useless as a patient must leave her home to have a telehealth visit with a physician

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Study: Public Has Poor Understanding Of Dementia

According to a new study, the majority of the public have limited knowledge about dementia and Alzheimer’s disease, with nearly two-thirds believing it’s a normal part of aging.

Researchers from the Trinity College of Dublin and St. James’s Hospital’s Dementia Services Centre in Ireland analyzed twenty years’ worth of articles on dementia from 15 countries as part of the study. The results show that the general public’s understanding of dementia is lacking, with a large majority unsure of when a normal age-related memory loss crosses the threshold to dementia.

The most common misconception was that it’s a normal part of the aging process, according to researchers. Many people also failed to understand modifiable risk factors, such as smoking and high blood pressure, which can influence the disease’s progression.

Researchers note the lack of understanding could ultimately lead to those with dementia experience stigma, embarrassment and social isolation.

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Special Update on Overtime Litigation

The U.S. Supreme Court denied the Application for a Stay of the Court of Appeals ruling in the lawsuit challenging the U.S. Department of Labor rule changes affecting minimum wage and overtime compensation for home care aides and live-in personal care services. The challenged rules will go into effect on or about October 13, 2015.

NAHC and its co-plaintiffs are evaluating further litigation options in this case.

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