CMS releases proposed FY 2018 inpatient payments, policies
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on April 14 issued a proposed rule that would update FY 2018 Medicare inpatient payments and policies. Among the changes, the rule: would increase payment rates by 1.6%, after accounting for inflation and other adjustments required by law includes an…
CMS interim rule delays bundled payment programs
Editor's Note In an interim final rule, the Centers for Medicare and Medicaid Services (CMS) has delayed expansion of the Comprehensive Care for Joint Replacement (CJR) bundled payment program and implementation of its bundled payment programs for cardiac care from July 1 to October 1, 2017, the March 20 Modern…
Bill to repeal, replace Affordable Care Act released
Editor's Note The 123-page bill, called the “American Health Care Act,” was released March 6, Modern Healthcare reports. The bill replaces the Affordable Care Act’s (ACA’s) income-based premium tax credits with age-based tax credits. It also enhances federal funding for states to expand Medicaid to low-income adults, and it converts…
Executive order pushes back implementation of bundled payment models
Editor's Note An executive order by President Donald Trump that freezes new regulations has pushed back implementation of new and expanded Centers for Medicare & Medicaid Services (CMS) bundled payment models by 60 days, the February 20 Home Health Care News reports. Mixed feelings continue in the healthcare industry as…
CMS immediate jeopardy trail may lead to the OR
What makes an OR subject to an immediate jeopardy finding from a Medicare inspection? Immediate jeopardy is cited when a provider’s noncompliance with one or more of the Centers for Medicare & Medicaid’s (CMS) Conditions of Participation causes or is likely to cause serious injury, harm, impairment, or death. …
Colon resection complications that affect outcomes
Editor's Note Anastomotic leaks and postoperative ileus had significantly higher associations with 30-day patient outcomes after colon resection than surgical site infections (SSIs), urinary tract infections, and venous thromboembolism, this study finds. In 26,682 patients undergoing colon resection, the most common postoperative complications were ileus (11.8%), bleeding (7.6%), and incisional…
Tools lacking to assess readmission risks after joint replacement
Editor's Note The Centers for Medicare & Medicaid Services (CMS) and care providers lack the predictive models needed to assess risks for readmission after joint replacements, finds this study. Researchers tested the applicability of the Carlson Comorbidity Index, Elixhauser Comorbidity Index, and CMS Hierarchical Condition Category to see whether any…
Use of high-, low-quality hospitals by uninsured
Editor's Note Despite the Affordable Care Act, which was designed to improve access to care for patients without insurance, patients without insurance have lower use of high-quality hospitals, this study finds. The probability of admission to high-quality hospitals was similar for patients with Medicaid (23.3%) and private insurance (23.0%), but…
ACS notifies members of CMS software errors
Editor's Note The American College of Surgeons (ACS) on January 20 notified members that it had received a letter from the Centers for Medicare & Medicaid Services (CMS) saying new moderate sedation codes that took effect January 1 were incorrectly bundled into several surgical procedures codes in CMS payment software.…
CMS extends deadline for reporting 2016 quality data
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on January 17 announced a deadline extension for reporting CY 2016 electronic Clinical Quality Measure data to avoid a 2.7% payment adjustment in FY 2018. The extension applies to hospitals and critical access hospitals participating in the Hospital Inpatient Quality…
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