## Evolving Compliance Regulations for Skilled Nursing Facilities (SNFs)

Evolving compliance regulations for skilled nursing facilities (SNFs) create a potential paradox. While the data-driven nature of skilled care demands increased access to digital information that helps inform patient treatments, improve outcomes, and implement effective cost-management strategies, these new processes also introduce the potential for compliance compromise. Here’s why: as SNFs streamline staff access to critical information, they must also ensure that they are meeting regulatory requirements.

## Coding and Billing for Physical Therapy

When it comes to coding, physical therapy billing guidelines for Medicare and physical therapy billing units, the instructions are quite specific. From service-based billing codes to time-based billing codes — and the anticipated Medicare 8-Minute Rule (aka Medicare Rule of 8’s) — proper documentation as it pertains to outpatient therapy services is crucial to receive the correct reimbursement.

## Mastering MIPS: Unlocking the Secrets of CMS’s Merit-Based Payment System

In the realm of U.S. healthcare, particularly for those involved in providing rehab therapy services, the introduction of the Medicare payment program, MIPS (Merit-Based Incentive Payment System), has significantly shifted the dynamics. If your practice caters to Medicare patients, understanding MIPS is essential for navigating the complexities of reimbursement.

## Compliance Risk Management in Healthcare

In the complex and highly regulated healthcare landscape, compliance risk management plays a crucial role in ensuring patient safety, protecting sensitive information, and mitigating legal and financial risks. Healthcare organizations must develop robust strategies to effectively implement compliance risk management practices. This involves identifying, assessing, and addressing compliance risks associated with patient care and service delivery.

## PTA/OTA Supervision Guidelines Post-PHE

With the expiration date of the COVID-19 Public Health Emergency (PHE) on May 11, 2023, we have reviewed and updated the following questions regarding the supervision requirements of a physical therapist assistant (PTA) by a physical therapist (PT) and an occupational therapy assistant (OTA) by an occupational therapist (OT) under Medicare Part B outpatient therapy services.

## Setting Up a Group Practice in an Assisted Living Facility

Have you ever considered how you might go about delivering rehabilitation services in the home or in an assisted living facility? Setting up a group practice is one way of doing this. It can be as simple as two therapists setting up a business together, or as complex as a company with multiple locations employing various therapists to provide comprehensive care.

## Locum Tenens Services for Physical Therapists

Since 2017, physical therapists whose outpatient clinics are located in rural, medically underserved, and health professional shortage areas have been able to hire a qualified substitute provider (aka a locum tenens) on a short-term basis. This locum tenens program in Medicare allows these physical therapists and a discreet list of physician types to hire temporary help as needed.

## Improving Seniors’ Timely Access to Care Act

Medicare Advantage (MA) plans are able to require providers to obtain prior authorization for certain medical treatments or tests—including physical therapy care—before they can provide care to their patients. Recent reports from the Department of Health & Human Services’ Office of the Inspector General (OIG) have highlighted concerns regarding this practice and its impact on patient access to necessary therapies.

## Continuation of the COVID-19 Public Health Emergency

On October 13, 2022, the COVID-19 Public Health Emergency (PHE) was renewed. While this PHE has been renewed multiple times since being declared in 2020, this could be the last time, with the PHE potentially expiring on January 11, 2023. Each renewal of the PHE determination is effective for 90 days.

## Wound Care Providers and Regulatory Compliance

At night, do you dream about PDPM, MACRA, MIPS and all the regulations that must be met in today’s heavily regulated health care environment? Understanding the numerous acronyms can be overwhelming, but acquiring the necessary knowledge about compliance can provide peace of mind.

## Complying with the 21st Century Cures Act

As October arrives, healthcare providers using electronic health record systems (EHRs) — including those in wound care — will need to ensure their EHRs are compliant with the 21st Century Cures Act to maintain efficient operations and meet regulatory mandates.

## Coping With Expiration of the COVID Public Health Emergency

On July 15, 2022, the U.S Secretary of Health and Human Services renewed the public health emergency (PHE) posed by COVID. These last-minute renewals have provided healthcare workers more resources to treat COVID patients, offering a range of expanded healthcare options and rules.