Recently, the AACVPR published a Health Policy & Reimbursement Update. Here’s a helpful breakdown of what that means for you and your organization:
SUMMARY OF AACVPR HEALTH POLICY & REIMBURSEMENT UPDATE
Federal Regulation under Medicare Part B for outpatient Cardiac and Pulmonary Rehabs are only covered if: they are medically necessary and be provided in accordance with an individualized treatment plan and include physician exercise and a psychosocial assessment.
ITP (INDIVIDUALIZED TREATMENT PLANS) HIGHLIGHTS
Each ITP needs to be established, reviewed, and signed by a physician every 30 days. The plan needs to be written and tailored to each individual patient. Goals need to be set for each individual. Pulmonary Rehab must include some aerobic exercise and other techniques such as breathing and retaining. The plan also must also include a psychosocial evaluation.
ACTION THAT SHOULD BE TAKEN IN RESPONSE TO HEALTH POLICY & REIMBURSEMENT UPDATE
Implement written policies and procedures to ensure all services and documentation is in accordance with medical requirements.
LSI TRENSCENTER ADVANTAGE
LSI products have a built-in ITP that is totally customizable. We will work with you to make sure your current ITP follows Medicare Compliance and AACVPR Certification. Also, the LSI TrensCenter has a built-in Smart Calendar and Scheduling Assistant which will help manage clinical work deadlines (such as the 30 day physician signature–a strict protocol within the Medicare Reimbursement guidelines). Additionally, LSI has built-in Psychosocial assessments such as the Dartmouth, Ferrans, and Powers that will calculate their score.
For more information, read the full audit of the cardiac and pulmonary rehabilitation program in New Jersey referenced in the AACVPR report.
Note: AACVPR Members receive regular monthly Health Policy & Reimbursement Updates via email. Members of AACVPR can also access the Health Policy/Reimbursement Discussion Forum, which allows members to share information, ask questions and access resources to address their reimbursement challenges.