APDA ADVOCACY ACTION
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The APDA Advocacy team needs to hear your voice! APDA is in the initial stage of forming our APDA Political Action Committee. LEARN MORE HERE ABOUT APDA PAC and 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.
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.
May 6-12, 2021 Celebrate National Nurse Week
Celebrate a nurse. No Matter the day or circumstance, nurses make a difference in our society. A nurse sharing their experience is emplowering and especially powerful with their accounts of inspiration, accomplishments, challenges and how they continue to thrive through difficut times.
May 5, 2021 Radiologists ask Congress for $3B to offset looming cuts in the Medicare Physician Fee Schedule
Radiologists and other physicians are asking Congress to inject another $3 billion into the Medicare Physician Fee Schedule to offset looming doc pay cuts slated for 2022.
May 4, 2021 Home care start up acquires Mobile X-ray Company, Professional Portable X-ray (PPX)
“By integrating our expertise in mobile imaging with DispatchHeath’s unique technology-enabled care model, the company is uniquely positioned to become the marketplace for in-home healthcare services nationwide,” Professional Portable X-Ray CEO and co-founder Sue McNamee said in a statement in Radiology Business News
April 30, 2021 CMS Fiscal Year 2022 Medicare LTCH proposed rule
Changes to dual eligible medicare/medicaid patients-43 states do not pay full or any cost sharing amounts for dual eligible patients. If states pay less than such cost-sharing amounts, certain Medicare providers may submit these unpaid cost-sharing amounts to Medicare for payment as reimbursement for “bad debt.”
April 28, 2021 With continued increase of elderly turning to Medicare Advantage plans, SNFs consider not to accept these plans.
Medicare Advantage’s aggressive market penetration represents a major threat to skilled nursing providers, some of whom now find themselves clearing less per resident day through MA plans than they do in state Medicaid programs. Plans disregard star ratings and tell SNFs "Here's the rate, Here’s the patient. Take it, or we’ll find somebody else. ”
April 26, 2021 CMS once again updating 855B from version 7/23 to version 3/24 in some states effective
CMS released a revised version of the CMS-855B . This revised version (03/24) replaced the previous version 07/23. Some states are already accepting this revised version and accepting the previous version 07/23 until June 30 with applications received after that date on version 07/23 being returned. Please check with your Carrier. To prevent impacts to your application processing, always access the most current version of the form from the CMS website: CMS-855B or utilize PECOS.
April 23, 2021 DOJ to launch Ransomware and Digital Extortion Task Force
The Task Force will target the entire ransomware ecosystem as a whole. The aim is not only to bring the individuals conducting the attacks to justice, but also any individuals who assist attackers, including those who launder ransom payments.
April 22, 2021 25th HCCA Compliance Institute conference lays out 10 Key Compliance Priorities
OIG enforcement will be focusing on priorities that range from Cybersecurity, Telehealth, Modernizing access to care and more.
April 20, 2021 New Info blocking rules - Patient's right of access regulations now effective
The regulations that went into effect apx 10 days ago were introduced to prevent information blocking, which is the practice of interfering with access, exchange, and use of electronic health information or EHI. NOTE: The practice of blocking/delaying or refusing requests for patient records and supporting documentation from referring physicians, facilities and other healthcare entities IS NOW OUTLAWED. Providers can report those who are non compliant The ONC is encouraging all stakeholders to report cases of information blocking, as complaints inform its enforcement efforts. Providers can file complaints with ONC-Learn More
.April 16, 2021 Biden's 400B plan to shift Long Term Care home -what could that mean for Nursing Homes? Could Nursing Homes become purely Acute Care Centers?
"The proposal, part of the president’s $2 trillion infrastructure overhaul package, would seek to reduce the baked-in preference that many state Medicaid programs have for institutional nursing home care"
April 15, 2021 Biden signs bill dealying 2% Medicare Sequestration cut until 2022
The legislation will extend the moratorium through Dec. 31. The measure also contains some technical corrections related to rural health clinics and disproportionate share hospitals.
April 13, 2021 California AG files lawsuit against Brookdale Senior Living for manipulating data
Per Healthcare Finance news "....the lawsuit accuses Brookdale of illegally transferring and discharging residents "so it can fill its beds with residents who will bring in more money."
April 12, 2021 CMS proposes changes to Skilled Nursing Facility Prospective Payment System
Blood-clotting factors used for the treatment of patients with hemophilia and other bleeding disorders will be excluded from the consolidated billing requirements for items and services furnished on or after October 1. As a result, CMS is proposing a proportional reduction in the Medicare Part A SNF rates to account for this new exclusion.
April 12, 2021 One-Home partners with the next generation Medicare Advantage Plan Devoted Health
Instead of being the middleman One Home teams up with payers by entering into full-risk capitation agreements for skilled home health care. One home says, “We’ve got our own home health agencies, our own 40,000-square-foot DME warehouse in the markets we’re in. We’ve got our own fleet of vehicles. We’ve got our own pharmacies.”
April 9, 2021 HHS final rule on information blocking and interoperability now in effect
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.
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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.
Key Dates and Summary of requirements for recipients that received over $10,000 in aggregate of PRF (provider relief funds) :
- 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
Use your smartphone to tell CDC about any side effects after getting the COVID-19 vaccine. You’ll also get reminders if you need a second vaccine dose.
March 9, 2021 CDC issues first set of guidelines how fully vaccinated persons can visit safely
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:
Dynarad/National Imaging Solutions
2021 Midyear Exhibitors:
Dynarad/National Imaging Solutions
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 »