Log in

Articles

<< First  < Prev   1   2   3   4   5   ...   Next >  Last >> 
  • 17 Jun 2018 5:27 PM | Leah Lenz (Administrator)

    Click the link to view: IACPR Newsletter Spring 2018.docx

  • 18 Jan 2018 4:55 PM | Leah Lenz (Administrator)

    Kim Eppen PT, PhD, provides a summary of the presentation she gave at the AACVPR conference in 2017, regarding outcomes in pulmonary rehabilitation.

    FIFTH POST

    Join the IACPR now to view this article in the Members Only section.

     

  • 16 Nov 2017 4:36 PM | Leah Lenz (Administrator)

     Janie Knipper RN, MA, AE-C, MAACVPR, provides insight into collaborative self-management with the pulmonary rehab population. Collaborative self-management describes the combined efforts of the health care team and the patient/family to meet the needs of the patient in relation to the management of their chronic lung disease. The goal of self-management training is to empower the patient at all stages of disease.

    FOURTH POST

    Join the IACPR now to view this article in the Members Only section.

  • 10 Nov 2017 3:36 PM | Leah Lenz (Administrator)

    Janie Knipper RN, MA, AE-C, MAACVPR, provides details regarding the reasons for low reimbursement rates for pulmonary rehabilitation, what AACPVR is doing to try to improve them, and what pulmonary rehabilitation professionals need to do to help.

    THIRD POST

     Join the IACPR to view this article in the Members Only section. 

  • 6 Nov 2017 7:09 AM | Leah Lenz (Administrator)

    More depth is provided, by Janie Knipper RN, MA, AE-C, MAACVPR, regarding Medicare policy and reimbursement for pulmonary rehabilitation, in 2018.

    SECOND POST

    Join the IACPR to have view this article in the Members Only section

  • 1 Nov 2017 3:36 PM | Leah Lenz (Administrator)

    IACPR members, Janie Knipper RN, MA, AE-C, MAACVPR and Kim Eppen PT, PhD, gave multiple presentations regarding various aspects of pulmonary rehabilitation, at the national conference, in October.  In the next few weeks, the summary of each presentation will be posted.  This is valuable information an well worth your time.

    In this article Janie Knipper applies her decades worth of knowledge to provide a summary of the components necessary to create a comprehensive pulmonary rehab program

    FIRST POST

    Join the IACPR now to view this article in the Members Only section.

     

  • 6 Jul 2017 6:26 AM | Leah Lenz (Administrator)

     An inquiry was sent to WPS to seek clarification on a question raised at the IACPR Conference in April:

    In June of 2016, WPS replied to a series of questions posed by the J5 MAC Committee.  In the reply, WPS responded that not only pulmonary rehab ITPs, but cardiac rehab ITPs  must be signed by the physician prior to the patient’s first treatment session. This is not in the CR regulations (Code of Federal Regulations), but it is in the PR regulations.  So we asked for clarification again regarding the need for the CR physician to sign the treatment plan prior to the patient's first treatment session. 

    The response from WPS is as follows:

    Thank you for the inquiry you sent to Wisconsin Physicians Service (WPS) Government Health Administrators (GHA) regarding cardiac rehabilitation.  I contacted our Medical Review department including our Contractor Medical Director (CMD) for assistance with your inquiry. The Medical Review staff and CMD indicates, the cardiac rehabilitation treatment plan is considered an order and must be signed prior to treatment in order to be valid. The physician’s order is written prior to the services being done to document the services being ordered.

    It is surprising WPS is calling the ITP an “order”, but they are so we need to follow this rule.  Please contact Janie Knipper if you have further questions about this.

    Thank you!

    Janie

    Janie Knipper, RN, MA, AE-C

    Pulmonary Rehabilitation Supervisor

    University of Iowa Hospitalsand ClinicsIowa City, IA 52242

    P: 319-356-8396F: 319-353-7199

    Email: jane-knipper@uiowa.edu

     

  • 27 Jun 2017 3:32 PM | Leah Lenz (Administrator)

    Please take time to read this important document!  The future of pulmonary rehabilitation depends on each and every one of us!  The following provides important information to make you aware of the AACVPR’s efforts to improve reimbursement for pulmonary rehab, and it involves you taking action in each of your hospitals.  Please read carefully, and contact Janie Knipper, jane-knipper@uiowa.edu with any questions.  More information will be coming as this effort continues to move forward.

    IACPR Reimbursement Update June 2017

    Pulmonary rehabilitation programs are struggling to remain financially viable in this ever-changing health care environment, and the AACVPR is ready to take on the challenge of improving reimbursement for pulmonary rehabilitation services (G0424).  Please read and tak action!

    In 2010, when CMS authorized use of HCPCS code G0424 for billing of pulmonary rehab services, the Agency admitted it had no historical data on which to base a payment amount, and arbitrarily assigned a payment amount of $50.  Unfortunately, as the years passed and CMS collected data on which to base its payment rate, the reimbursement rate for pulmonary rehab decreased rather than increased!  In the November 30, 2011 Federal Register (page 74224, establishing payment for pulmonary rehab), CMS explicitly stated,

                Hospitals should be especially careful to thoughtfully establish charges for new codes     that use a single code to report multiple services that were previously reported by   multiple codes.  It is vital in these cases that hospitals carefully establish charges that    fully include all of the charges for all of the predecessor services that are reported by             the new code.  To fail to carefully construct the charge for a new code that reports a             combination of services that were previously reported separately, particularly in the       first year of the new code, under-represents the cost of providing the service . . .

    Plain and simple:  programs or persons responsible for rate setting for G0424 did not identify all of the beneficial services that are provided in one session pulmonary rehab, and therefore set very low rates for one session of G0424.  In response to this problem, all the pulmonary societies combined their efforts to create the Pulmonary Rehabilitation Reimbursement Toolkit (available on the AACVPR website – www.aacvpr.org).  The Toolkit provided a guide for programs to identify the broad array of services integral to pulmonary rehabilitation that must be considered when computing the charge that must appear on all claims submitted to Medicare. 

    Unfortunately, in 2017, it appears that many hospitals have still not adjusted the charge for G0424 to reflect the full hour of services!  The AACVPR recently invested in significant data mining associated with G0424, focusing on several key parameters:

    • 1.     How many hospitals in the U.S. bill Medicare for code G0424, and how many claims does Medicare pay?
    • 2.     What are the hospital charges for G0424 associated with every specific hospital, by name and address?
    • 3.     What has CMS computed to be the costs associated with pulmonary rehab services, based on the data the hospital has provided integral to its annual hospital cost report?

    The key findings are as follows:

    • 1.     Nearly 1350 hospitals billed Medicare for code G0424 in 2015, the most recent year for which data are available.  These include hospital outpatient services only.  It does not include critical access hospitals as those hospitals receive their payment based on different payment methodologies.
    • 2.     The actual number of claims submitted by those hospitals range from a high of over 3000 claims to a low of 11.
    • 3.     The range of charges is from a high of $1981/session to a low of $44/session.
    • 4.     The range of costs is from a high of $1265/session to a low of $4.00/session.

    This data was vital for the AACVPR as they examined ways to focus future plans to secure appropriate payment for pulmonary rehabilitation services.  The AACVPR formed the PR Reimbursement Task Force to work with the MAC Liaison Task Force and the MAC Resource Groups (MRGs) to move this project forward. 

    Based on recommendations of the PR Reimbursement Task Force, a charge amount threshold of $400/session was chosen.  All hospitals with charges of $400 or higher were eliminated from the work sheet.  The AACVPR MAC Liaison Task Force and the MRGs are now charged with collecting additional data from programs charging <$400/session, and who submitted > 250 G0424 claims/year.  This is not to say that those programs submitting < 250 G0424 charges/year are not important. The premise is that the impact on Medicare aggregate calculations from the smaller programs would be minimal.  In addition, by cutting the original number of hospitals from 1350 to 680, the effort becomes more manageable.

    There are only 12 pulmonary rehab programs in Iowa that have submitted > 250 G0424 charges/year.  The MAC Liaison, Janie Knipper, will be contacting each program to gather additional information.  But the rest of us are not off the hook!  Even if you are not one of the 12 programs, we ALL must revisit the Pulmonary Rehabilitation Reimbursement Toolkit, and schedule meetings with our Chargemaster or whoever is responsible for your rate setting.  Share the Toolkit with those people so they better understand the tremendous amount of time and energy involved in one session of pulmonary rehab (G0424).  As stated above, the first goal is to encourage ALL programs to establish a charge of > $400/session for G0424.  It is clear this will take communication between the AACVPR, pulmonary rehab program directors, hospital CEOs, and hospital CFOs.  Stay tuned for more news as additional data is collected and this project moves forward    

  • 5 May 2017 2:21 PM | Julie Feirer (Administrator)

    The AACVPR had provided some additional resources related to the impending CMS changes to cardiac rehab bundles and incentive payment models. It is AACVPR’s goal to provide all cardiac rehabilitation professionals with resources and tools to help you and your local members/attendees prepare for the changes that will inevitably affect your programs. The following are links to the information video.

    1.      We have provided the file via Dropbox for easy download – you may distribute this link via email: https://www.dropbox.com/sh/k21qb8xdnfgemm6/AAB6KQ7dSWp5vz2zFCrLLVrba?dl=0

    2.      We have posted the video to YouTube – you may distribute this link via email: https://youtu.be/O1deVWCbE3s

    If you have any questions accessing the video, please let AACVPR know. They are committed to our continued effort to provide you with up-to-the minute information regarding these changes to your programs. Please don’t forget to visit the AACVPR website for more information on the  Roadmap to Reform Resource Page and the Regulatory & Legislative Information Page.

    Thank you! 

    American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR)

    330 N. Wabash Avenue, Suite 2000, Chicago, IL 60611

    Main Line: 312321-5146

    Fax: 312673-6924

    Email: aacvpr@aacvpr.org

    Web: www.aacvpr.org  

    Connect with us on Facebook

  • 16 Aug 2016 12:46 PM | Julie Feirer (Administrator)

    The AACVPR has created a webpage, “What’s New in My MAC?”, as a resource for members to stay updated with all MAC news/updates. Unfortunately, it can be difficult to find.

    Follow this link: https://www.aacvpr.org/Advocacy/Whats-new-in-my-MAC ,
    and sign in to access the “What’s New in My MAC?” page.

<< First  < Prev   1   2   3   4   5   ...   Next >  Last >> 
© Iowa Association of Cardiopulmonary Rehabilitation


Powered by Wild Apricot Membership Software