CMS clarifies ICD-10 implementation issues
Editor's Note The Centers for Medicare and Medicaid Services (CMS) reports that it will reprocess ICD-10 claims with National Coverage Determination and Local Coverage Determination errors automatically and at no cost to providers. CMS is also waiting to reprocess some claims with errors resulting from Local Coverage Determinations until Medicare…
EHR adoption up, but challenges continue
Editor's Note Electronic health record (EHR) adoption has increased since 2010, but small and rural hospitals need strategies to address financial challenges now that penalties for lack of adoption have begun, this study finds. Using 2008-2014 national data, researchers found that 75% of hospitals have adopted at least a basic…
OIG announces new initiatives for ASCs
Editor's Note The US Department of Health & Human Services Office of the Inspector General (OIG) released its 2016 Work Plan announcing new initiatives for ambulatory surgery centers (ASCs), the ASCA News Digest reports. The initiatives include: Review the appropriateness of Medicare’s methodology for setting ASC payment rates. Revitalize outdated…
Build a strong anesthesia quality program to boost patient safety and the bottom line
Quality indicators for anesthesia For the past several years, physicians have participated in the Physician Quality Reporting System (PQRS) established by Medicare as a way to assess the quality of patient care and tie that to reimbursement. Beginning in 2015, a negative payment adjustment hit individuals and group practices whose…
Disaster planning exercises prepare ASCs to care for patients and assist communities
Ambulatory surgery centers (ASCs) are taking a new look at the question of disaster response. Staff are not always informed about what emergencies might occur, or what they should do in response to the most likely scenarios. Likewise, many local emergency management agencies are not even aware of the ASCs…
CMS finalizes rule for hip and knee bundled payments
Editor's Note The Centers for Medicare and Medicaid Services (CMS) has finalized the rule that will require hospitals in 67 geographic areas to participate in a test of bundled payments for hip and knee replacements, Modern Healthcare reports. Medicare's average bundled payment ranges from $16,500 to $33,000 for surgery, hospitalization,…
Medical societies plead with Congress to fix ‘meaningful use’
Editor's Note A coalition of 111 medical societies on November 4 sent letters asking Senate and House leaders to take legislative action to pause Stage 3 of the electronic health records meaningful use program and revise Stage 2 so that it enables provider success, HealthData Management reports. Stage 3 requirements…
CMS denies 10% of claims under new ICD-10 codes
Editor's Note The Centers for Medicare & Medicaid Services (CMS) rejection rate of Medicare fee-for-service claims submitted with the new ICD-10 codes was 10.1% in October. Invalid use of ICD-9 codes resulted in the rejection of 0.11%, and 2% were not accepted because of invalid or incomplete information. More information…
Medicare releases 2016 final ASC payment rule
Editor's Note On October 30, the Centers for Medicare & Medicaid Services (CMS) released the final 2016 payment rule for ambulatory surgery centers (ASCs). ASC payment rates will increase by 0.3%, which is based on a projected inflation rate of 0.8% minus a 0.5% productivity adjustment required by the Affordable…
CMS finalizes 2016 payment rules for physicians, hospitals
Editor's Note The Centers for Medicare & Medicaid Services (CMS) has issued its final rules detailing how it will pay for services provided by physicians and other healthcare professionals in 2016. Key policies finalized in the rules include: Updates to the “Two-Midnight” rule, which clarifies when inpatient admissions are appropriate…
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