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:: NAHC Report
NAHC Report: Issue# 2172, 4/11/2013
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MedPAC Chairman Testifies at House Subcommittee Hearing on Medicare Benefit Design
CMS Issues Fact Sheet on the Jimmo v. Sebelius Settlement Agreement
For Your Information: Registration Open for CMS Medicare National Provider Call on Transitioning to ICD-10 in 2013
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MedPAC Chairman Testifies at House Subcommittee Hearing on Medicare Benefit Design
NAHC Offers Written Testimony for the Record Opposing Home Health and Hospice Copays

On April 11, 2013 MedPAC Chairman Glenn Hackbarth testified before the House Energy and Commerce Subcommittee on Health at a hearing entitled, “Strengthening Medicare for Seniors: Understanding the Challenges of Traditional Medicare's Benefit Design.” Mr. Hackbarth was the hearing’s only witness, and offered the Subcommittee members MedPAC’s perspective on Medicare’s benefit design – and particularly on proposed changes to cost sharing within the program.

Throughout the hearing, Subcommittee members asked Mr. Hackbarth about possible changes to Medicare’s plan design – including MedPAC’s recommendation to add a catastrophic cap on out-of-pocket costs, proposals for a universal deductible for parts A and B of Medicare, MedPAC’s suggestion to add a charge for supplemental Medicare (Medigap) policies, and general inquiries into whether or not Medicare’s benefits package was generous enough or too generous for current and future beneficiaries. Several members of the Subcommittee offered their support for a combined deductible for Parts A and B, while others asked about home health care specifically.

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Registration Open for CMS Medicare National Provider Call on Transitioning to ICD-10 in 2013

Join CMS experts on April 18 from 1:30 to 3:00 p.m. ET as they discuss ICD-10 planning and preparation strategies. Following the presentation, CMS representatives will be available for a question and answer session. Below is a draft of the call’s agenda:

  • Planning for transition to ICD-10
  • Claims processing
  • National implementation issues
  • National Coverage Decisions
  • Outreach

The target audience for this call includes medical coders, physicians, physician office staff, nurses and other non-physician practitioners, provider billing staff, health records staff, vendors, educators, system maintainers, laboratories, and all Medicare FFS providers.

In order to receive call-in information, you must register for the call on the CMS Medicare Upcoming National Provider Calls registration web page. If you can’t make the call, the presentation will be posted on the CMS Medicare FFS National Provider Calls web page. Additionally, a link to the slide presentation will be emailed to all registrants on the day of the call.

Continuing education credit may be awarded for participation in certain CMS National Provider Calls. Visit the Continuing Education Credit Notification web page to learn more.

Visit the CMS ICD-10 website for the latest news and resources to help you prepare for the October 1 ICD-10 transition.

Visit the CARING Store online for the latest Resources

CMS Issues Fact Sheet on the Jimmo v. Sebelius Settlement Agreement

CMS has issued a fact sheet on the Jimmo v. Sebelius settlement agreement. The settlement puts an end to the Medicare contractors inappropriately applying an “Improvement Standard” in making claims determinations for Medicare coverage involving skilled care. The fact sheet is the first of several education initiatives CMS will be undertaking in the coming months. In addition, CMS will be revising the program manuals used by the Medicare contractors.

In the case of Jimmo v. Sebelius, the Center for Medicare Advocacy (CMA) alleged that Medicare claims involving skilled care were being inappropriately denied by contractors based on a rule-of-thumb “Improvement Standard”— under which a claim would be denied due to a beneficiary’s lack of restoration potential, even though the beneficiary did in fact require a covered level of skilled care in order to prevent or slow further deterioration in his or her clinical condition.

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Director of Compliance
Community Health Systems Professional Services Corporation
Community Health Systems Professional Services Corporation seeks a Director of Compliance for its Franklin, TN, headquarters’ Corporate Compliance (Home Care Division) team. The Director of Compliance is a liaison to an assigned group of home health and hospice agencies.
Essential Duties and Responsibilities: Ensure full implementation of the CHS Corporate Compliance Program at each agency assigned to the Director. Develop training and education programs for regulatory changes and topics identified as potential risk areas. Structure tools for use with compiling data and trend analysis. Assess auditing and monitoring trends and coordinate mitigation activities when opportunities for improvement (audit variances) are identified. Prepare oral and written reports, including recommendations for improvement based on audit and investigative findings. Monitor Compliance Committee minutes to ensure adequate follow-up of potential risk areas. Maintain an awareness of current laws, statutes, regulations, etc. that impact healthcare operations and physician relationships. Conduct focused compliance audits on topics of concern. Coordinate compliance policy development and/or revision, when necessary. Participate in compliance and privacy investigations. Other duties as assigned by the VP, Corporate Compliance and Privacy Officer. This position will require travel up to 40% of the time.
Education/Experience: The Director must have current experience working within the Home Health and Hospice industry and should be familiar with reimbursement methodologies and regulations pertaining to benefit coverage. Bachelor’s degree in Health Information Management, Nursing, Business, or related area, or three or more years’ experience in compliance functions. The Director must have the ability to plan, develop, and present educational or programmatic materials in front of an audience greater than 20 people.
To apply for this job, please visit the career section of and apply to Job Number 1254993.

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