Reimbursement Sleep Labs
Beginning
January 1, 2011, Medicare Contractors in Texas, New Mexico,
Florida, Oklahoma, and Colorado,
will require The Joint Commission Accreditation or
ASAM accreditation for all non-hospital providers of
Medicare sleep tests as a condition of payment. Other Medicare
contractors are also beginning to move towards implementation of
accreditation of the sleep lab as a condition to Medicare
reimbursement. Commercial insurance carriers are also moving towards application of this trend. While the
extent and contours of sleep testing and therapy delivery are in
flux, opportunities abound for those who can creatively assemble
the new and evolving technologies in sleep. Deena Weiss and
Associates will assist you in your accreditation and
compliance with this new law now before the 2011 deadline. Sleep
industry participants should stay attuned to more changes as
this decade unfolds.
The Government's Agenda is focused on Sleep.
Every year, the Office of Inspector General publishes its Work
Plan for the upcoming year which lists those Medicare service
areas that the OIG intends to study as possible pockets of
program fraud and abuse. Sleep testing has appeared in the Work
Plan every year since 2007. The OIG seeks to examine the
appropriateness of Medicare payments for sleep studies,
compliance with Medicare billing requirements, and what has
enabled the massive rise in Medicare payments for sleep studies
during the past few years .
As rules of the
game change sleep medicine is experiencing greater scrutiny. It
is crucial that labs pay close attention to rapidly changing law
and policy. Failure to play by the rules can have costly
repercussions that can stain a business' reputation
and diminish their profits. One way sleep labs can decrease
the risk of regulatory sanctions is by implementing a Medicare
Compliance Plan. Effective compliance plans can help providers
remedy noncompliant services or billing before it becomes too
late. Deena Weiss and Associates works closely with several
attorneys who specialize in health care law to implement an
effective Compliance Plan.
Eating Disorder Providers and
Insurance Reimbursement
Eating Disorder providers now
need to be accredited as a condition of payment for
insurance and Medicare reimbursement.
