Shumaker Manufacturing

A Legal & Industry Review

“Medicare Home Health Payment Update: Florida and Other States are Required to Submit Their Home Health Claims for Pre-Claim Review”

The Centers for Medicare and Medicaid Services (“CMS”) is implementing a new pre-claim review process for home health claims in five (5) states, including Florida.  Other affected states are Illinois, Texas, Michigan, and Massachusetts.  CMS’ stated goal is to make sure home health services are medically necessary without delaying or disrupting patient care or access.  The pre-claim review will begin in Florida no earlier than October 1, 2016 and the other states will be phased in during 2016 and 2017. Continue reading

Client Alert: CMS to Physicians: QPP Reporting 2017 “Have it Your Way”

On August 8, 2016, the Centers for Medicare & Medicaid Services (“CMS”) announced in a blog post reminiscent of a Burger King commercial that physicians and other clinicians can indeed “have it their way” when reporting for the first year of the Quality Payment Program (“QPP”).  CMS received nearly 4,000 comments to the QPP rules proposed in April.  The American Medical Association and other physician advocates urged delay in the reporting requirements while others felt a delay would unfairly penalize those who have been preparing for new reimbursement systems.  CMS also fielded questions at a Senate Finance Committee hearing in July and CMS Acting Administrator Andy Slavitt indicated at that time that CMS was open to different approaches. Continue reading