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September 2012

Health and Human Services Secretary Announces Compliance Date for ICD - 10

On August 24, 2012, Health and Human Services, (HHS) Secretary Kathleen Sebelius announced the release of a rule that makes final a one-year proposed delay—from October 1, 2013, to October 1, 2014 in the compliance date for the industry's transition to ICD-10 codes. Secretary Sebelius first announced the proposed delay in April, as part of President Obama's commitment to reducing regulatory burden. The deadline for the transition to ICD-10 is October 1, 2014.

SSA Announces 61.5 Million People are Receiving $63.5 Billion

During August of 2012, the Social Security Administration (SSA) released a Monthly Statistical Snapshot Report from July 2012 showing 61.6 million Americans receiving Social Security and/or Supplemental Security Income totaling $63.5 billion.

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The Centers for Medicare and Medicaid Services (CMS) announced a Decision Memo regarding Transcutaneous Electrical Nerve Stimulation (TENS) units

CMS released a recent Decision Memo that addressed conditions for coverage of a TENS unit for Chronic Low Back Pain (CLBP). The recent change in coverage of TENS units for CLBP will have the following impacts upon the WCMSA proposal review process for Medicare Set Asides:

  • Effective June 8, 2012, for those workers' compensation (WC) Medicare Set Aside cases settled prior to June 8, 2012, and where the settlement included pricing for TENS for CLBP, CMS will consider funds spent for TENS for CLBP by beneficiaries and claimants as being an appropriate expenditure of funds as part of the WCMSA.
  • For those Workers Compensation cases that were not settled prior to June 8, 2012, and where the WCMSAs proposal includes funding for TENS for CLBP as part of the WCMSA, CMS will re-review the cases and remove pricing for TENS for CLBP. (Regional Offices shall obtain from submitters requests for a case re-review, along with a signed statement indicating a settlement had not occurred prior to June 8, 2012.)

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