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Legislative Updates

• Legislative Corner. Does Incorrect Coding Lead to Medicare Denials?: Apr - Jun, 2012
• Legislative Corner. Appealing a Medicare or Insurance Denial: Jan – Mar, 2012
• Legislative Corner. LE Bill Redux: From H.R. 4662 to H.R. 2499: Oct - Dec, 2011
• Legislative Corner. Making a Medicare or Insurance Claim: Jul - Sep, 2011
• Legislative Corner. Medicare Changes in 2011: Apr - Jun, 2011
• Legislative Corner. About H.R. 4662 2010: Jan - Mar, 2011
• Medicare at a Threshold Part 3. Lobby Trip, NLN IAC, Bill Changes: Oct - Dec, 2010
• Medicare at a Threshold Part 2. Update Lymphedema Bill 2010: Jul - Sep, 2010
• Medicare at a Threshold Part 1. MEDCAC, Coding, Denials: Apr - Jun, 2010
• Legislation Update: Medicare MEDCAC, Pump Claims Coding: Jan - Mar, 2010
• Lymphedema Insurance and Legislation Update. NC Law: Oct - Dec, 2009
• Lymphedema Insurance and Legislation Update. State Bills NY, NC, MA Jul - Sep, 2009
• Lymphedema Insurance and Legislation Update. NY Bills Apr - Jun, 2009
• Lymphedema Insurance and Legislation Update. Grass Roots Advocacy Jan - Mar, 2009
• Lymphedema Insurance and Legislation Update. New York Bills Oct - Dec, 2008
• Lymphedema Insurance and Legislation Update. State Bills Jul - Sep, 2008
• Lymphedema Insurance and Legislation Update. Apr - Jun, 2008
• Groundbreaking Medicare Appeals Council Decision. Feb 2008
• Lymphedema Insurance and Legislation Update. 75% Rule, Medicare Denials: Jan - Mar, 2008
• Legislation Update. NJ Resolution & NY Lymphedema Bill: Oct - Dec, 2007
• Summary of State Lymphedema Bills. Jul - Sept, 2007
• Therapy Caps Exception Process 2007. Repeal of Caps & Garment Non-Coverage: Apr – Jun, 2007
• Medicare Coverage of Compression Items: Jan - Mar, 2007
• Progress on the Medicare Coverage Front: Oct - Dec, 2006
• 2006 Mid-Year Lymphedema Legislation Update: Jul – Sep 2006
• Lymphedema Legislative Update (As of Feb 15, 2006): Apr – Jun, 2006
• Lymphedema Legislative Summary (As of Nov 22, 2005): Jan – Mar, 2006
• Legislative Update State Bills & Resolutions: Apr – Jun 2005
• Lymphedema Legislative Summary May 2004 Federal & State Bills: Jul - Sep 2004

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Lymphedema Insurance & Legislation Update: Apr-June 2008

 By Robert (Bob) Weiss, MS, LE Legislative Advocate

Federal

Implementation of the “75% Rule” and deletion of the therapy cap exception process were both delayed by Congress until June 30, 2008 when, on December 29, 2007, President Bush signed the Medicare, Medicaid and SCHIP Extension Act of 2007 (Act) into law, extending the State Children's Health Insurance Program (SCHIP).

The Act extends the Medicare therapy cap exception process through June 30, 2008. If Congress had not acted to extend the exception process through June 30, 2008, the Medicare Physician Fee Schedule Final Rule for 2008 would have imposed a combined therapy cap of $1,810 per beneficiary for OPT and OSP, and a separate cap of $1,810 for OOT, beginning January 1, 2008. Unless Congress repeals the therapy caps or further extends the therapy cap exception process prior to July 1, 2008, the therapy caps will take effect when the Act's extension expires on June 30, 2008.
The Act also contains a number of other provisions impacting Medicare providers and suppliers, such as provisions freezing the inpatient rehabilitation facility compliance threshold at 60% instead of 75% and allowing certain co-morbidities to count toward that threshold.

California

California Assembly Bill No. 1214 Emmerson Waiver of benefits that would have made current healthcare mandates optional was withdrawn from consideration by its author after it became apparent it would not pass the Health Committee.

New York

The New York State Breast Cancer Network has agreed to actively support NY A.07077 Maisel/S.01544 Fuschillo lymphedema diagnosis and treatment bills. They are drafting a letter of support on behalf of their member organizations that will be used as part of their legislator briefings on Advocacy Day on in Albany. The NLN has sent letters of support to the Chairmen of the Insurance and Health Committees urging favorable action on these bills.

Assembly Bill A.05889 Maisel passed the full Assembly last June and is now being considered in the Senate as S04266 Golden. This legislation, sponsored by the Lymphatic Research Foundation, would establish a lymphedema and lymphatic disease research grants program. Grants, not to exceed fifty thousand dollars, would be awarded on a competitive basis to biomedical research institutions that are conducting direct research related to lymphedema and lymphatic disease.

Robert "Bob" Weiss, M.S.
NLN LE Legislative Advocate

 

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