APDA ADVOCACY ACTION
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APDA'S WORK FOR ITS MEMBERS AND THE INDUSTRY PAYS OFF!
NOVITAS CUTS ARE AVERTED! 6% MPFS CUT IS AVERTED!
THANKS to the tireless effort of the APDA team and its dedicated members and consulting partners, Novitas has announced today 1/4/2021 that NO states will see an R0070 reimbursement cut until after the PHE. Some states will see an increase. UPDATE- March 2021 - Novitas has discussed APDA's and the PXR community's concerns and understands the affects reimbursement cuts can have at this time. They agreed to re-survey the transportation rates prior to making any additional pricing changes beyond the increases that have already been implemented.....reinforcing NO CUTS until a resurvey.
The APDA Advocacy team needs to hear your voice! Stay tuned to this website, APDA emails and newsletters as we ask for your help in making noise on the Hill to EDUCATE our representatives and the healthcare industry on Portable Diagnostics and its value, possibly REMOVE portable diagnostics from consolidated billing (part A), FIGHT for fair and equal transportation reimbursement for ALL states and PUSH for Fair inclusion in COVID waivers and provider relief funds.
can sign onto this website and go to Resources tab/member communications section to read legislative updates, newsletters and more.
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April 18-24, 2021 Health Information/Medical Records Professionals Week.
Celebrate the impact health information professionals have on the quality of patient care around the globe. As COVID-19 has shown, health data and your work are more important than ever. Health information professionals are trusted by patients and providers alike to protect, interpret, and transmit the most sensitive data that exists about a person, while making sure it is available where and when it is needed. This year’s theme emphasizes or reminds us that as health information professionals we keep health information human, and when health information stays human, it stays relevant.
The new information blocking and interoperability regulations developed by the Department of Health and Human Services as part of the 21st Century Cures Act took effect on Monday this week. The final rule defines information blocking and stipulates the penalties for providers that engage in activities that interfere with access, exchange, and use of electronic health information (EHI).
April 8, 2021 CMS proposes an increase of approximately $444 million in Medicare Part A payments to SNFs in FY 2022
On April 8, 2021, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility (SNF) prospective payment system (PPS) for fiscal year (FY) 2022. Proposed rule CMS1749-P.
April 5, 2021 CMS begins to recover more than $100B in advanced and accelerated payments
The federal government last week began recovering the extra Medicare payments sent to nursing homes and other health care providers during the initial height of the coronavirus crisis last year.
April 1, 2021 Plan for increased medicaid funding for home health care
"The Money Follows the Person (MFP) program, which encourages states to develop Medicaid-covered alternatives to nursing homes and other institutional long-term care settings"
March 31, 2021 OIG reports over $11M Medicare overpayments made to Pt B providers for claims that were to be billed under Part A arrangement
Medicare made incorrect payments to outpatient providers for 40,984 nonphysician outpatient services provided nation-wide within 3 days before the date of admission, on the date of admission, or during IPPS stays (excluding date of discharge) that we reviewed. These incorrect payments occurred because the Common Working File (CWF) edits were not designed to accurately identify all potentially incorrect claims.
March 31, 2021 Temporary Claims Hold Pending Congressional Action to Extend 2% Sequester Reduction Suspension
In anticipation of possible Congressional action to extend the 2% sequester reduction suspension, CMS instructed the Medicare Administrative Contractors (MACs) to hold all claims with dates of service on or after April 1, 2021, for a short period without affecting providers’ cash flow. This will minimize the volume of claims the MACs must reprocess if Congress extends the suspension; the MACs will automatically reprocess any claims paid with the reduction applied if necessary.
March 30, 2021 President signs PPP loan extension deadline to May 31, 2021
March 25, 2021 Senate passes bill avert sequestration cuts until the end of the year
The Senate today passed by 90-2 vote a bill that, among other health care provisions, would eliminate the 2% across-the-board cut to all Medicare payments, known as sequestration, until the end of 2021. To pay for the change, the bill would increase the fiscal year 2030 sequester cuts.The House is expected to take up the Senate-passed bill the week of April 13 when it returns to Washington D.C. It is expected that the Centers for Medicare & Medicaid Services will hold the Medicare claims until the bill is signed into law as it has done in the past.
March 19, 2021 The Trend is looking to overhaul the employer health self insured market with at risk contracts to share in employer savings.
Groups rely on their "own findings for saving money through researching sites of care". Providers include telehealth, hospitals, physician and ?Radiology services.
March 18, 2021 Tax filing & payment deadline for individuals extended to May 17, 2021
The Treasury Department and Internal Revenue Service announced today that the federal income tax filing due date for individuals for the 2020 tax year will be automatically extended from April 15, 2021, to May 17, 2021. The IRS will be providing formal guidance in the coming days.
March 17, 2021 Amazon expands its in-house healthcare to other companies. Is there room for portable diagnostics?
Per Washington Post, Amazon Care service uses an app on iOS or Android to connect people over text or video chat with a doctor or nurse. If the doctor determines its necessary, they may send prescriptions or arrange a home visit for the patient. Messaging is free for Amazon employees on qualified company health plans, and video calls and home visits cost a small fee, the company said.
March 16, 2021 Its time to ramp up your compliance! Healthcare fraud recoveries will be record numbers in 2021.
Per Healthcare Finance "The Biden Administration said they're going to take violations very seriously," Smith said. "Making this a lead priority, they're going to get very aggressive in investigations. And if you look back at history to predict the future, remember, Biden was vice president for Obama for eight years, and the Obama Administration was extremely invested in prosecutions related to the Great Recession. They were ruthless in their investigations and prosecution. I think we're going to see a 2.0. Many Biden appointees worked with the Obama Administration, so there's a memory of what happened before.
March 10, 2021 Learn about CMS' Amended repayment process for accelerated and advance repayments
Recently, Congress enacted amended repayment terms for the accelerated and advance payments through the Continuing Appropriations Act, 2021 and Other Extensions Act: Repayment will now begin one year after the date of the issuance of the payment. During the first 11 months after repayment begins, repayment will occur through an automatic recoupment of 25% of Medicare payments otherwise owed to you. During the succeeding six months, repayment will occur through an automatic recoupment of 50% of Medicare payments otherwise owed to you. If you are unable to repay the total amount of the accelerated or advance payment through recoupment within 29 months, you will receive a demand letter requiring repayment of any outstanding balance, subject to an interest rate of 4%.
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COVID 19 INFORMATION AND UPDATES APDA encourages members to stay vigilant and monitor this Website Daily along with these sites:
CDC NEWS AND UPDATES, CMS NEWS AND UPDATES , HHS News Releases, and Cares Act Provider Relief Fund updates
Click on this COVID UPDATES link for ALL updates & links to helpful resources.
THIS WEEK'S COVID 19 HEADLINES:
- January 15, 2021 Reporting Portal opens for Providers
- Feb. 15, 2021: first reporting deadline for all providers on use of PRF funds (on January 15, 2021, HHS has announced that THIS DEADLINE HAS BEEN DELAYED-with deadline date to be determined). Read More
- July 31, 2021: final reporting deadline for providers who did not fully expend PRF funds prior to December 31, 2020
- SEE UPDATED REPORTING REQUIREMENTS POSTED 10/22/20
February 10, 2021 Fraud Alert Covid 19 Scams
Fraudsters are offering COVID-19 tests, HHS grants, and Medicare prescription cards in exchange for personal details, including Medicare information. However, these services are unapproved and illegitimate. Offers to purchase COVID-19 vaccination cards are scams. Valid proof of COVID-19 vaccination can only be provided to individuals by legitimate providers administering vaccines.
January 12, 2021 HHS extends Public Health Emergency til April 2021
Health and Human Services Secretary Alex Azar announced the renewal on Thursday ahead of its expiration on Jan. 21. With this fourth iteration, the public health emergency will cover another 90 days, stretching into April.
January 15, 2021 PRF first reporting deadline of February 15, 2021 is DELAYED
The federal government on Friday 1/15/21 issued a formal delay of its reporting requirements for health care providers that received COVID-19 financial relief.
December 18, 2020 Is it safe to accept vaccines from SNFs after finding care facilities are hit with scams?
As reported in AARP magazine, criminals are targeting not only individuals but also care facilities....describing a phony “pharmaceutical representative” who offered to sell a residential care facility a number of vaccines to inoculate its patients and staff.
December 2, 2020 Options to Reduce Quarantine days using symptom and diagnostic monitoring
Per CDC, "Quarantine can end after Day 10 without testing and if no symptoms have been reported during daily monitoring.
When diagnostic testing resources are sufficient and available..., then quarantine can end after Day 7 if a diagnostic specimen tests negative and if no symptoms were reported during daily monitoring."
IT'S NOT TOO LATE!
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APDA 2021 Midyear Conference
May 11th-12th, 2021 - Chicago, IL
Thank you for your Support!
2021 Midyear Sponsors:
2021 Midyear Exhibitors:
Rayance & MyVet
RCN Consulting Solutions
Congratulations Will Irwin! Will Irwin received an unexpected visit during Day 3 of the APDA Virtual Conference Member Business meeting. Michael Straecke, APDA Emeritus, Sharon Reilley, APDA Administrator and Ken Andrews APDA member from K & A X-ray showed up at Will's office (while he was on Live during the Virtual meeting) to present him with the engraved Waterford Crystal Decanter Tom Wuerstle Founders Award, commemorating Will's years of dedicated service. Michael gave a very warm and well deserved speech thanking Will for his years of dedication and tireless service to APDA. Congratulations WILL, Well Deserved!Read More »
Stay informed with APDA Covid 19 Updates Read More and Leave a CommentRead More »
Exciting News! Great Win for APDA members and the Industry! On September 26, 2019, the Centers for Medicare & Medicaid Services (CMS) finalized a rule to modernize the Portable X-ray Conditions of Coverage (CoC). As a result of joint advocacy efforts by the American Portable Diagnostics Association(APDA) and the National Association for the Support of Long-term Care (NASL), with support from AMDA – the Society for Post-Acute and Long Term Care Medicine. UPDATE to changes 9/30/2019 The final rule updating the Portable X-ray Conditions of Coverage (CoC) was published in today's edition of the Federal Register (September 30, 2019). This means the changes become effective in 60 days – November 29, 2019. Here is a link to the final rule published in the Federal Register: https://www.govinfo.gov/content/pkg/FR-2019-09-30/pdf/2019-20736.pdfRead More »