Regulatory Relief for Outpatient Reporting in Proposed CMS Rule

Changes to Part B reporting could be come on January 1

The comprehensive Medicare Part B Physician Fee Schedule (PFS) Proposed Rule for Calendar Year (CY) 2019 includes a provision for regulatory relief for providers in the area of outpatient therapy reporting, sources said.

The Centers for Medicare & Medicaid Services (CMS) want to discontinue the functional limitation reporting (FLR) requirement for Part B rehabilitation therapies (physical and occupational therapy as well as speech-language pathology services) starting in 2019.

For several years, the American Health Care Association (AHCA) has requested CMS make this change.

The issue originated in 2013, when CMS required Part B therapy providers to submit “Functional Limitation Reporting” codes on physical therapy, occupational therapy, and speech language pathology claims upon admission, at frequent intervals, and at discharge, or payments would be rejected.

Now, industry sources said CMS proposes to eliminate the regulation in response to AHCA and other stakeholder comments submitted under a Request for Information on CMS Flexibilities and Efficiencies issued in the CY 2018 PFS proposed rule.

Although not speaking directly to the LT/PAC sector, Miranda Franco, a senior policy advisor with the law firm Holland & Knight, tells Provider that the theme thus far of the Trump administration when it comes to health care is grounded heavily in regulatory relief.
The fact sheet is available on the CMS website.


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