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…
Readmissions associated with hospital characteristics
Editor's Note Select hospital characteristics are associated with readmissions after major surgical procedures, this study finds. After adjusting for patient factors, rural location was predictive of readmission after colectomy. Low-volume and minority-serving hospitals were associated with greater odds of readmission after total joint arthroplasties. Because financial penalties may worsen performance…
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 finalizes rule on prior authorization for durable medical equipment, supplies
Editor's Note The Centers for Medicare & Medicaid Services (CMS), on December 30, 2015, published a final rule that establishes a prior authorization process for certain durable medical equipment, prosthetics, orthotics, and supplies to help reduce unnecessary and fraudulent claims. Under the final rule, the same information necessary to submit…
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 issues notice on ‘two-midnight’ rule payment cut
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on December 1 published a notice with comment period on the basis for cutting inpatient hospital payments by 0.2% in accordance with its “two-midnight” rule. The notice comes in response to an October 6 court ruling that challenged the payment…
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