The previously determined, January 31, 2020, public health emergency (PHE) has been extended by Secretary, Xavier Becerra, for an...

Through extensive PDPM analytics, QRM’s audit team has identified myths surrounding qualifiers for PDPM components, with a goal of...

On April 15th, the Secretary of Health and Human Services, Xavier Becerra acknowledged the ongoing COVID-19 pandemic and exercised his...

CMS Announced on April 8th, the ending of the following waivers that were initiated in response to the existing Public Health Emergency...

Depression potential as captured within the MDS PHQ9 interview has taken on significant attention under the PDPM reimbursement model. ...

Update 3/26 We have learned the CMS webinar registration for live viewing is now full - however, you can register to receive a...

As we see and hear, Medical Review activity is on the rise. To help prepare, QRM’s VP of Medical Review and Clinical Reimbursement has...

Confirming this year's Part B Fee Schedule was quite the waiting game with the last minute flurry from CMS. We have pulled together the...

Texas Quality Incentive Payment Program for Nursing Homes (QIPP) Year 5 Updates (Eff 2/1/2021): Eligibility: Roster attached for QIPP...

January 7th, Health and Human Services Secretary, Alex Azar, renewed the Public Health Emergency (PHE) related to COVID-19 through his...

1/8 In follow up to our earlier notice of the 6 new COVID related diagnosis, CMS has now completed and posted an update to the PDPM...

12/28 The president has signed the Consolidated Appropriations Act of 2021 (COVID Relief Act) mitigating, in part, the looming Part B Fee...

Effective 1/1/21, the CMS-R-131 Advanced Beneficiary Notice of Noncoverage (ABN) form will be required for the following 2 reasons: Part...

QRM’s Clinical Reimbursement Specialist, Megan Ussery, RN, RAC-CT has provided Clarification surrounding CMS’ new additions to COVID...

December 10th, Senator Boozman (R-AR) introduced S.5007 the companion bill to H.R. 8702 – Holding Providers Harmless From Medicare Cuts...

CMS has published Updates to the Nursing Home Compare Website and Five Star Quality Rating System (12/4/2020 Ref: QSO21-06-NH), resuming...

December 1st, CMS released the CY 2021 Medicare Physician Fee Schedule Final Rule. In this Final Rule, CMS is finalizing its proposals...

Jan 1, 2021 Medicare Fee Schedule Cuts are scheduled to take place reducing PT/OT reimbursement by an estimated 7% and ST by 9%. There...

October invoicing marks the beginning of FY 2021. CMS has made several adjustments impacting accurate rate calculations - which go into...

From QRM’s office of Medical Review Author: Ashley Duggan, OTR, RAC-CT, Vice President of Medical Review and Clinical Compliance With...