New ACS Interactive Web Tool Helps Surgeons Avoid Medicare Penalties
Editor's Note The American College of Surgeons has launched a new web tool to help surgeons navigate and succeed in Medicare’s mandatory quality programs: Physician Quality Reporting System, Electronic Health Record-Meaningful Use, and Value-Based Modifier. Surgeons who do not successfully participate in these programs in 2015 could face up to…
CMS Issues Proposed Rule for Hospital Outpatient and ASC Payments
Editor's Note The Centers for Medicare & Medicaid Services on July 1 issued a proposed rule for CY 2016 for the hospital outpatient prospective payment (OPPS) and ambulatory surgical center (ASC) payment systems. CMS proposes an OPPS decrease of .01%. The change is based on a projected hospital market basket increase…
CMS Proposes Changes to the 'Two-Midnight' Rule
Editor's Note On July 1, the Centers for Medicare & Medicaid Services released proposed updates to the “Two-Midnight” rule regarding when inpatient admissions are appropriate for payment under Medicare Part A. The proposed update allows physicians to use their judgment to admit patients for short hospital stays on a case-by-case…
Editorial
Reports that emerged in late 2014 reflect both progress and problems in healthcare delivery. And while regulatory and financial hurdles continue to loom large in 2015, some of these obstacles are being cleared. The Agency for Healthcare Research and Quality cited an impressive 1.3 million decline in the number of…
CMS replaces flash sterilization with IUSS
The Centers for Medicare & Medicaid Services (CMS) has replaced the term “flash sterilization” with “immediate use steam sterilization” (IUSS) in surgical settings. The change in terminology, which applies to Medicare-participating hospitals, critical access hospitals, and ambulatory surgical centers that are subject to Conditions of Participation or Conditions of Coverage,…
Sharpen coding skills and reimbursement strategies during ICD-10 delay
The Centers for Medicare & Medicaid Services (CMS) once again has extended the deadline to begin using International Classification of Diseases-10 (ICD-10) billing codes. Implementation has been set for October 1, 2015, and a growing number of billing, technology, and clinical specialists agree it is time to move ahead with…
Medicare reimbursement, allowable procedures at forefront of ASC challenges
Leaders of ambulatory surgery centers (ASCs) can expect to continue facing challenges related to reimbursement even as they try to increase the kinds of procedures that can be performed in their facilities, say experts with the Ambulatory Surgery Center Association (ASCA). Other key factors that will determine their future success…
CMS issues proposed hospital inpatient payment rule
The Centers for Medicare & Medicaid Services (CMS) on April 30 issued its proposed rule that would update FY 2015 Medicare payment polices and rates for inpatient stays at general acute care and long-term care hospitals. The proposed rule will increase the payment rate to general acute care hospitals by…
ASCs face learning curve as quality reporting goes online
Computers and computer-driven devices have transformed the way healthcare is delivered, and use of the technology has led to greater efficiency, error reduction, and the ability to perform some previously impossible procedures. However, it is not always easy to incorporate computer tools into traditional activities such as quality tracking and…
Anticipate & educate to navigate murky healthcare reform waters
Anxiety over changes in healthcare delivery and payment systems has permeated hospitals and ambulatory surgery centers (ASCs). Administrators are concerned about how the Affordable Care Act (ACA) and other initiatives will hit the organization’s bottom line. Increasingly, perioperative services leaders are being drawn into discussions in these areas. “The OR…
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