Articles and Blogs

Hall, Render, Killian, Heath & Lyman is pleased to announce associate attorney Elizabeth P. Mitchell, MHA, has joined the firm’s Indianapolis office. Mitchell is a member of the Business Transactions and Services practice group where she focuses on legal matters related to regulatory and corporate compliance, physician agreements and corporate transactions. She graduated from... READ MORE

As an update to the previous post on the revalidation enrollment procedures it is important for hospices, home health agencies, and DMEPOS to know what level of screening they will receive from the Medicare Administrative Contractor (“MAC”).  In some instances these providers and suppliers will be screened at either a “high” or “moderate” level... READ MORE

In an effort to reduce fraud, waste and abuse of the Medicare program, the Affordable Care Act (section 6401A) implemented new risk screening criteria that require revalidation of enrollment by providers and suppliers who enrolled in the Medicare program prior to Friday, March 25, 2011.  Under the new screening criteria, newly-enrolling and revalidating providers... READ MORE

As of March 2011, the Centers for Medicare & Medicaid Services (CMS) implemented new screening criteria in the Medicare provider/supplier enrollment process.  Newly enrolling and revalidating providers and suppliers are placed in one of three categories – limited, moderate, or high – each representing the level of risk to the Medicare program for that... READ MORE

As stated in the Health Law News article, for certain types of non-IPPS hospitals the statutory payment window is only one (1) day preceding the patient’s admission.  To clarify, those non-IPPS hospitals are psychiatric hospitals and units, inpatient rehabilitation hospitals and units, long-term care hospitals, children’s hospitals and cancer hospitals.  Critical access hospitals are... READ MORE

The Centers for Medicare and Medicaid Services (“CMS”) published the FFY 2012 Final Rule for the Inpatient Rehabilitation Facility (“IRF”) Prospective Payment System (“PPS”) in the Federal Register on August 5, 2011. The Final Rule provides for a 2.2% increase to IRF payment rates for FFY 2012 and implements other adjustments, including updates to... READ MORE

Hall, Render, Killian, Heath & Lyman is pleased to announce associate attorney Anne M. Ruff, J.D., has joined the firm’s Milwaukee office. Ruff is a member of the Health practice group where she focuses on legal matters related to medical staff relations and regulatory and compliance. She graduated from the University of Wisconsin-Madison with... READ MORE

Hall, Render, Killian, Heath & Lyman is pleased to announce associate attorney Joseph R. Krause, J.D., has joined the firm’s Milwaukee office. Krause is a member of the Health and Business/Tax practice groups focusing on legal matters related to business transactions and services, reimbursement and tax and tax exemption. He attended the University of... READ MORE

On August 1, 2011, the Centers for Medicare and Medicaid Services (CMS) issued its Fiscal Year (FY) 2012 Inpatient Prospective Payment System (IPPS) Final Rule clarifying which outpatient services are required to be bundled with inpatient services in submission of Medicare claims.  This billing policy is commonly known as the 3-Day Window Rule and... READ MORE

While Congress was able to present the President with a compromised solution to cut Federal spending and raise the Government’s debt ceiling earlier this month, all long-term care providers should anticipate future reimbursement changes.  Under the current law, the Budget Control Act of 2011t , Medicare and Medicaid are unchanged. However, the Act requires for... READ MORE