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Stay on Top of Medicare Changes With Latest APTA Fact Sheets

Published: Feb 6, 2017

Here's a quick rundown of some recent additions. Note: the links will take you to a general webpage on a particular topic—to access the members-only fact sheet, scroll down to the "APTA Fact Sheets and Summaries" header.

Home Health Conditions of Participation Final Rule
CMS brought its home health participation rule out of the 1990s by issuing its first revision to the rule in more than 20 years. The new rule establishes minimum standards for home health agencies that want to serve Medicare and Medicaid beneficiaries.

Episodic Payment Model Final Rule
"Episodic payment" is CMS-speak for bundled payment systems. The new rule includes requirements for bundling programs related to cardiac care in 98 metropolitan areas, and expands the range of activities covered under the Comprehensive Care for Joint Replacement (CJR) model that required bundling for total knee and total hip arthroplasties.

Orthotics and Prosthetics Proposed Rule
This fact sheet covers a proposed rule from CMS that would include physical therapists (PTs) among the providers who could furnish and bill for custom orthotics and prosthetics—provided the PTs meet certain qualifications.

Medicaid Appeals Final Rule
CMS has added provisions to improve coordination between Medicaid, the Children's Health Insurance Program (CHIP), and health exchanges under the Affordable Care Act. In turn, the rules governing how consumers contest eligibility decisions have changed.

The latest APTA fact sheets join information on the 2017 physician fee scheduleoutpatient payment, and home health payment. APTA regulatory affairs staff continually monitors developments at CMS and publishes fact sheets as new rules are proposed or implemented.

Need information on getting through Medicare fraud and abuse probes? Check out this APTA "flipped classroom" course on audits and review—listen to a prerecorded presentation, then join a live Q-and-A session on February 9 to get your questions answered.

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