Health Information Management

The week in Medicare updates

APCs Insider, February 28, 2014

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Implementing Operating Rule 350 
On February 14, CMS issued a change request to facilitate compliance with the Coalition for Affordable Quality Care Committee on Operating Rules for Information Exchange-mandated Operating Rule 350: Dual Delivery of Electronic Remittance Advice (ERA) and Standard Paper Remittance, for 31 days after ERA enrollment by trading partners. 
Effective date: July 1, 2014
Implementation date: July 7, 2014 
 
View Transmittal R1345OTN.  
View related MLN Matters® article MM8570.
 
 
Medicare Fee-For-Service ICD-10 testing approach 
CMS outlines its approach to testing for ICD-10 in an MLN Matters Special Edition article issued February 19. 
Effective date: October 1, 2014. 
 
View MLN Matters Special Edition article SE1409.
 
Cardiac rehabilitation programs to add chronic heart failure diagnosis
 
CMS received a formal request from the American Association of Cardiovascular and Pulmonary Rehabilitation, American College of Cardiology, American Heart Association, and Heart Failure Society of America for a national coverage determination (NCD) to add the diagnosis of chronic heart failure (CHF) to the list of approved indications for coverage for cardiac rehabilitation (CR). The Medicare Improvements for Patients and Providers Act of 2008 established coverage for CR programs and in 42 CFR 410.19 established indications for coverage and program components. The addition of any cardiac indication for coverage of CR can only be done through the NCD process. On February 18, CMS issued a decision memo stating that the evidence is sufficient to expand coverage for cardiac rehabilitation services to beneficiaries with stable CHF.
 
View the request. 
View the decision memo.
 
 
Publication of final rule for CLIA program and HIPAA Privacy Rule; patient access to test reports
 On February 7, HHS published a final rule in the Federal Register stating that patients should have access to their personal health information, including laboratory test reports. The CLIA regulations at §493.1291(f) have been revised and a new regulation has been added at §493.1291(l). The HIPAA Privacy Rule was amended at 45 CFR §164.524 to remove the exceptions that relate to CLIA and affect an individual’s right of access. This change preempts any contrary provisions of state law. 
 
View the final rule.
 
National Uniform Billing Committee letter regarding use of 14x bill type
On February 18, CMS and HHS responded to a letter from George Arges, chairman of the National Uniform Billing Committee. Arges had voiced concerns from members regarding the billing policy for certain clinical laboratory services furnished by hospitals in 2014. 
 
Read the letter and response.
 
MLN Connects Provider eNews for February 20
CMS released its weekly MLN Connects newsletter.

View the newsletter.



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