Medicaid Archives | WebPT

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The Difference Between Medicare and Medicaid Billing and Reimbursement

At first glance, Medicare and Medicaid might seem like twins, or a dynamic duo, or two peas in a pod—basically, inseparable. They’re both government healthcare programs; they were both created at the same time; they’re both confusing and usually don’t boast the best reimbursement rates; and they even sound alike (they both start with “Medi-,” right?).

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Final Regulations for IDEA’s Early Intervention Program Released

On Tuesday, the US Department of Education released the long-awaited final regulations for the early intervention program under Part C of the Individuals with Disabilities Education Act (IDEA), a program that serves infants and toddlers through age 2 with developmental delays or conditions that have a high probability of resulting in developmental delays. These regulations will provide families, state agencies, early intervention service programs, and providers needed guidance. The department also released a notice of proposed rulemaking to amend the IDEA Part B regulations. The Part C regulations and Part B notice are both available on the department’s Web site and will be published in the Federal Register in the next couple weeks.  

Although IDEA was signed into law in 2004, this is the first time that final regulations incorporating the provisions in the 2004 amendments to Part C have been released. The regulations focus on measuring and improving outcomes for the approximately 350,000 children served by the Part C program, with the goal of ensuring that such children are ready for preschool and kindergarten.  
Changes are being proposed to the IDEA Part B regulations regarding cases in which a state or local educational agency seeks to use a child’s or parent’s public benefits or insurance (eg, Medicaid) to pay for Part B services. These proposed amendments to the Part B regulations would ensure the protection of the rights of parents and children and ensure that children with disabilities receive a free appropriate public education while addressing concerns raised by state and local educational agencies regarding the burdens imposed by the current regulation.
APTA staff is analyzing the new final Part C regulations and the IDEA Part B proposed rule. A more detailed summary will be available soon.

Source: PT IN MOTION

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APTA Provides Snapshot of Regulations under Affordable Care Act

The US Department of Health and Human Services (HHS) has released the final rule with comment period that will implement new provider screening and enforcement measures aimed at reducing fraudulent providers and suppliers from enrolling in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). The final rule also grants these federal programs authority to suspend payments when a credible allegation of fraud is being investigated.

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Webinar Update from CMS

The Centers for Medicare & Medicaid Services’ (CMS) Provider Communications Group will host a national provider conference call on the 2011 Physician Quality Reporting System and Electronic Prescribing (eRx) Incentive Program.

The eRx Incentive Program is an incentive program for eligible professionals initially implemented in 2009 as a result of section 132(b) of the MIPPA.  The eRx Incentive Program promotes the adoption and use of eRx systems by individual eligible professionals and beginning with the 2010 eRx Incentive Program, group practices.

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