“The IPA is an optional assessment. In the eyes of Medicare, that is very clear,” Zimmet Chief Operating Officer Michael Sciacca said during a webinar last week. “What we’re hearing from some of our clients is that some of the insurance companies are requiring it when there’s a [positive] change in condition, which I would certainly push back on.”
“The requirement to continuously change reimbursement levels, that administrative burden was the whole point of making this assessment optional in the first place.”
Sciacca and Zimmet partner Vincent Fedele, who is also chief operating officer of CORE Analytics, said there continues to be confusion around this — even though some software systems are made to alert and potentially stop providers from submitting IPAs that lower their reimbursement.