We wanted to make you aware of two recent changes of events regarding CMS.
First, as you probably know CMS recently awarded the J11 MAC to Palmetto. On June 1, 2010, the Centers for Medicare & Medicaid Services (CMS) announced that the U.S. Government Accountability Office (GAO) had received a protest of CMS’ award to Palmetto GBA.
This has resulted in a Stop-Work Order in accordance with Federal Acquisition Regulations. Palmetto has been directed to immediately stop all work in support of the contract. This Stop-Work Order is effective until the final resolution of the protest. A decision is anticipate from the GAO on or about September 8, 2010.
The second issue is in regards to Pulmonary Rehab. Final Pulmonary Rehabilitation (PR) instructions to local Medicare contractors were released on May 7, 2010. In a CMS publication, MLN Matters, published after all instructions to local Medicare contractors were released, the word, “lifetime” appeared in the informational publication in the description of PR services. It states, “Medicare will pay for up to two (2) one-hour sessions per day, for up to 36 lifetime sessions (in some cases, up to 72 lifetime sessions) of PR.” AACVPR and AARC will be working to further clarify this language but until that time it is recommended to speak with your compliance officers to discuss how to best handle this situation at your facility.