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Home   Benefits   Gov't Relations   Events   O&P Almanac   Job Listings Oct. 6, 2011
 
 
 


In This Issue

  • Supreme Court hears Medicaid case regarding right to challenge cutbacks
  • Institute of Medicine to release essential health benefit criteria recommendations on Oct. 7
  • White House releases deficit reduction plan, includes cuts to Medicaid and Medicare
  • PDAC requires product labeling as of Feb. 1, 2012
  • States embracing Medicaid managed care
  • SOLD OUT: AOPA's final coding and billing seminar of 2011
  • Register for AOPA's Oct. 12 audio conference, 'Developing Your Medicare Billing Compliance Plan'
  • AOPA's first-ever television PSA playing nationally and featured in NYC's Times Square


  • O&P NEWS


    Supreme Court hears Medicaid case regarding right to challenge cutbacks
    The New York Times    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    The Supreme Court started its new term on Monday with arguments in a difficult and consequential case over California's attempt to cut Medicaid payment rates. The justices were not focused on the ultimate question of whether state officials were entitled to address the budget crisis there by lowering payments to medical providers. Rather, they considered the threshold question of whether the providers and Medicaid recipients were entitled to sue over the move. The answer was obscured by a tangle of legal doctrines and practical concerns. Medicaid is a joint federal-state program that provides health care to poor and disabled people. States are not obligated to participate. If they do, they receive federal money and in exchange agree to pay rates "sufficient to enlist enough providers" to ensure that care available under Medicaid is similar to that available to other local residents. More

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    Institute of Medicine to release essential health benefit criteria recommendations on Oct. 7
    AOPA in Advance    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    The timeline mentioned by HHS to AOPA has held: the Institute of Medicine confirmed last week that it is still scheduled to release its recommendations to HHS on criteria to determine what should be included in the "essential health benefits" definition. Now, HHS is likely to proceed to take all data—including all of that which AOPA delivered through the various channels above, and begin to draft a proposed rule. Either during that writing process, or after they finish and publish a draft, AOPA expects that HHS will follow through on their promise to AOPA, and others, to provide opportunities for further dialogue with stakeholders, like the Amputee Coalition and AOPA, and we will, of course, take advantage of that opportunity when it is afforded us. AOPA will also respond to their proposed rule in force, and encourage every AOPA and AC member to do the same—but only after HHS has published their proposal. More



    White House releases deficit reduction plan, includes cuts to Medicaid and Medicare
    AOPA in Advance    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    On Sept. 19, the White House announced its promised plan for debt ceiling/deficit reductions and how it would pay for the American Jobs Act. The plan includes $320 billion in reductions over 10 years for Medicare and Medicaid. Specifically, the $320 billion in reductions rely on the extension of DME cuts to Medicaid, presumably mostly competitive bidding items, as well as cuts to SNF, rehabs, and post-acute care providers. Below are two documents (info from White House announcement) and a more comprehensive summary from AOPA's lobbying consultant Alston & Bird on big picture overview of what is on table for the supercommittee that is currently holding negotiations. Click here to read the White House's summary of its deficit reduction plan. More

    PDAC requires product labeling as of Feb. 1, 2012
    AOPA in Advance    Share    Share on
FacebookTwitterShare on LinkedinE-mail article
    The Medicare Pricing, Data Analysis, and Coding contractor has recently published an announcement effective Feb. 1, 2012, that any product that is subject to a PDAC coding verification review must be permanently labeled. According to the PDAC, the label must contain the manufacturer's name, product name and model number. The label on any product delivered to a patient must be identical to the label on the product submitted for coding verification, and must be permanent in nature. For diabetic shoes and inserts, the label must be on both inserts that make up a pair. More

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    States embracing Medicaid managed care
    American Medical News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    A nationwide survey of Medicaid managed care programs found that access to care under the plans is a perceived problem but that many states use managed care as a vehicle to coordinate care. Managed care includes Medicaid primary care case management programs and comprehensive and single-benefit Medicaid health plans, both nonprofit and for-profit. Of Medicaid's 54 million beneficiaries in 2010, half were enrolled in a managed care plan. An additional 16 percent were in a primary care case management program, and the remaining 34 percent were in Medicaid fee-for-service, according to the survey, released Sept. 13 by the Kaiser Family Foundation and Health Management Associates, a research and consulting firm. The report is based on information valid as of October 2010. More

    SOLD OUT: AOPA's final coding and billing seminar of 2011
    AOPA in Advance    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    Due to the overwhelming interest in AOPA's Mastering Medicare Advanced Coding & Billing Seminar all available spaces for the final seminar have been sold, and regrettably registration for the seminar is now closed. If you are still interested in attending the seminar contact Stephen Custer at (571) 431-0876 or scuster@AOPAnet.org and place your name on a waiting list. More

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    Register for AOPA's Oct. 12 audio conference, 'Developing Your Medicare Billing Compliance Plan'
    AOPA in Advance    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    Do you know the difference between fraud and abuse? Do you have a billing compliance plan in place? The DME MACs and the Office of Inspector General are taking a closer look at the billing practices of O&P facilities, and with this increased scrutiny, a well designed, effective billing compliance plan is paramount for any successful O&P business. The ability to make sure your own billing practices are sound may prevent unnecessary audits down the road. Join AOPA on Oct. 12 to learn how to develop a billing plan and understand why compliance is such an important part of your business operations. More

    All New WalkAnalyst 3.0
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    AOPA's first-ever television PSA playing nationally and featured in NYC's Times Square
    AOPA in Advance    Share    Share on FacebookTwitterShare on LinkedinE-mail
article
    AOPA has opened a new front on behalf of telling the story of O&P by teaming up with the Amputee Coalition to produce a public service announcement advertisement for television. The ad was intended to address the rise in state governments contemplating stripping O&P coverage to Medicaid beneficiaries in various ways. AOPA is hosting the video online at www.LimbsAreEssential.org and AOPA has created a "Take Action" advocacy page where anyone who wants to support O&P may send a letter to their state and federal legislators, urging them to join the fight to protect these vulnerable citizens with mobility impairments. So far, AOPA's PR consultant The PlowShare Group estimates that the PSA has been seen by 3.5 million viewers on major cable channels across the country. While the ad is appearing primarily on TV stations, one additional high-profile placement of the message was made possible through a grant from Otto Bock HealthCare this past June and the PSA aired on the Clear Channel SpectaColor Megatron in the heart of Times Square in New York City. Click here to see a picture of the PSA placement in Times Square. More
     


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    AOPA Insider
    Colby Horton, Vice President of Publishing, 469.420.2601   Download media kit
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