Tag Archives: Accuracy of Payments

Accuracy! Of Payments!

Because Payment accuracy is important. Kidding aside, it is important that we pay what we owe, and not more.

Section 3131 concerns Home Health Care, including a Study! Of Important Things!

Section 3132 is about Hospice care. With more studies, to ensure accuracy.

Section 3133 is about improvements to the Medicare Disproportionate Share Hospital Payments (discussed here: Medicare Disproportionate Share). They will look at empirical data for this. WOW!

Section 3134 looks at Misvalued codes in the Physician Fee Schedule. It identifies them, and validates the correct ones. And then presumably, but not terribly explicitly, fixes that.

Section 3135 is the Modification of Equipment Utilization Factor for Advanced Imaging Services. One thing that means is that if you have an imaging session, and they look at more than one part of your body, they will be able to charge 50% less for each successive part, rather than 25% less.

Section 3136 is a Revision in the Payment for Power-Driven Wheelchairs. You guessed it – The Scooter Store! It changes the appropriate section to indicate complex, rehabilitative, rather than just any old thing. We’ll see if this impacts their ads.

Section 3137 is the Hospital Wage Index Improvement. It actually takes things like geographical location into account. Amazing!

Section 3138 discusses the Treatment of Certain Cancer Hospital. Basically Cancer is expensive, so specialty hospitals might need more money. They will look into that.

Section 3139 is about Payment for Biosimilar Biological Products. These are things like insulin, interferon, growth hormone, etc. These are made within living cells, such as bacteria, or yeast. Because of this, they cannot be exactly reproduced, like a chemical drug. Therefore, you shouldn’t always substitute, like you should be able to for any other brand name and generic drug. This section just makes this explicit, and deals with how to properly pay for these.

Section 3140 is the Medicare Hospice Concurrent Care Demonstration Project. At this point, it is over, so, yeah.

Section 3141 is entitled APPLICATION OF BUDGET NEUTRALITY ON A NATIONAL BASIS IN THE CALCULATION OF THE MEDICARE HOSPITAL WAGE INDEX FLOOR. It is a short paragraph, but it would take a whole blog itself to explain well. In short, it has to do with the way they calculate whether something is budget neutral (doesn’t raise or lower the budget), and what year’s dollars to apply. Fun stuff.

Section 3142 is about a Study! On Urban Medicare Dependent Hospitals. Remember we discussed the Rural ones here: Rural Protections

Section 3143Protecting Home Health Benefits. They are protected. Rest easy.


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