Reliability of cost profiles for surgery based on Medicare data
Editor's Note Medicare data on payments for inpatient surgery are a reliable measure of hospital costs for commonly performed procedures, but are less reliable for lower volume procedures, this study finds. With increased emphasis on shifting risk from payers to providers through bundled payments and accountable care organizations, hospitals are…
CMS issues revised guidelines for 'two-midnight' rule
Editor's Note The Centers for Medicare & Medicaid Services (CMS), on January 1, issued revised guidelines on “Reviewing Short Stay Hospital Claims for Patient Status: Admissions On or After January 1, 2016.” Under the revised exceptions policy for admissions not meeting the two-midnight benchmark, Part A payment may be appropriate…
Meaningful Use to end in 2016
Editor's Note The Meaningful Use program will be ending some time in 2016, the Centers for Medicare & Medicaid Services acting administrator, Andy Slavitt, announced January 11. New value-based payment regulations demand a more streamlined regulatory approach, noted Slavitt, speaking at the J P Morgan Healthcare conference in San Francisco.…
Bill allowing MU Stage 2 hardship exemptions signed into law
Editor's Note A bill designed to make it easier for healthcare providers to receive hardship exemption from financial penalties for failing to meet Stage 2 meaningful use (MU) electronic health record (EHR) requirements was signed into law on December 28, 2015, the January 4, 2016, iHealthBeat reports. The bill ensures…
CMS announces ASC quality reporting appeals process
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on December 16 announced that ambulatory surgery centers (ASCs) subject to a reduction in Medicare outpatient payments in CY 2016 because of noncompliance with the ASC quality reporting program may submit a request for reconsideration by March 17, 2016. Eligible…
Congress considers MU incentives for ASCs
Editor's Note A Bill in Congress would enable ambulatory surgery center (ASC) physicians to receive the same payment incentives for meaningful use (MU) of electronic health records (EHRs) as physicians in other settings, according to the December 15 Healthcare IT News. Currently, physicians practicing in ASCs are excluded. The Electronic…
Medicare penalizes 758 hospitals for patient safety issues
Editor's Note The Centers for Medicare & Medicaid Services on December 9 announced that 758 hospitals will have a 1% reduction in Medicare payments for missing targets for hospital-acquired conditions. More than half (54%) of the hospitals were also penalized last year. Penalties are expected to total $364 million. Among…
Survey on transition to ICD-10 finds successes, challenges
Editor's Note A survey of 298 attendees at a November 9 KPMG webinar on the transition to ICD-10 gleaned the following responses: 28% said the transition had been smooth 51% found “a few technical issues but overall successful” 11% described the transition as a “failure to operate in an ICD-10…
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…
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…
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