CMS Finalizes One-Year Delay on ICD-10 to October 2014

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The CMS publishes a final rule changing the compliance deadline for converting the ICD-10 system of diagnostic and procedural coding to October 1, 2014 from October 1, 2013.

Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) Meetings

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The Management of Heart Failure with the Use of Ventricular Assist Devices MEDCAC Meeting will be held 11/14/2012.

Recovery Audit Prepayment Review

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Will allow Medicare Recovery Auditors (RACs) to review claims before they are paid to ensure that the provider complied with all Medicare payment rules.  The RACs will conduct prepayment reviews on certain types of claims that historically result in high rates of improper payments.  These reviews will focus on seven states with high populations of fraud and error-prone providers (FL, CA, MI, TX, NY, LA, IL) and four states with high claims volumes of short inpatient hospital stays (PA, OH, NC, MO) for a total of eleven states.  This demonstration will also help lower the error rate by preventing improper payments rather than the traditional “pay and chase” methods of looking for improper payments after they occur.  This demonstration will begin on August 27, 2012.  A special Open Door Forum will be held in August to discuss this demonstration and details will be posted here when available.


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Do you wonder how health care reform will impact your medical devices?  RPI can customize a summary of how health care reform will impact your business.  Contact us for a quote.


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Friday, July 7, 2012, CMS (Medicare) released the 2013 proposed regulation for Hospital Outpatient Prospective and Ambulatory Surgical Center Payment Systems.  CMS also released the 2013 proposed revisons to the Physician Fee Schedule and other Part B payment policies.  Comments are due to CMS no later than September 7, 2012.

Advisory Panel on Hospital Outpatient Payment

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The semi-annual meeting of the Advisory Panel on Hospital Outpatient, (the Ambulatory Payment Classification Panel) for 2012 is schedule for the following times.

  • Monday, August 27, 2012, 1 p.m. to 5 p.m. EDT
  • Tuesday, August 28, 2012, 9 a.m. to 5 p.m. EDT
  • Wednesday, August 29, 2012, 9 a.m. to 5 p.m. EDT

Affordable Care Act Largely Survives Supreme Court Scrutiny

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The Supreme Court today largely upheld the Affordable Care Act, including the mandate that individuals must purchase health insurance, calling the penalty a tax. The mandate was considered the most crucial question being judged by the court because invalidating it would have complicated other provisions required by the law. The court did say that the portion of the ACA that expanded Medicaid may be unconstitutional, and that states cannot be compelled to follow that portion of the law. The ACA is set to fully take effect in 2012.

The Washington Post (6/28), Los Angeles Times/Politics Now blog (tiered subscription model) (6/28), The Wall Street Journal (6/28)