A Comprehensive Error Rate Testing (CERT) study showed that insufficient documentation causes most improper payments for observation and inpatient care services, according to the January 2019 Medicare Quarterly Compliance Newsletter.
Thirty-eight hospitals filed a lawsuit against the U.S. Department of Health and Human Services (HHS) on January 18, alleging that that HHS Secretary Alex Azar overstepped his authority when he finalized an OPPS policy that cuts Medicare payment rates to off-campus, provider-based departments (PBD).
Many patients are making the shift from traditional Medicare plans to Medicare Advantage plans, and while these plans may have some advantages, they are also creating more headaches for case managers.
Despite facing potential lawsuits and political opposition, CMS finalized some of its most controversial proposals in the 2019 OPPS final rule by implementing several site-neutral payment policies and 340B drug payment reductions.
Along with E/M changes for 2019 and beyond, the 2019 Medicare Physician Fee Schedule final rule contains a plethora of regulations impacting reimbursement, including new modifiers for therapists.
A proposal to change discharge planning regulations has gotten new life. CMS announced last month that it is giving itself another year to publish the final version of the discharge planning rule.
In the 2019 OPPS final rule, released November 2, CMS implemented several site-neutral payment policies, though the agency did delay or shelve other proposals due to stakeholder feedback.
The American Hospital Association and American Medical Group Association recently commended CMS for delaying implementation of E/M payment policies proposed for implementation on January 1.
In the 2019 OPPS final rule, released Friday, November 2, CMS implemented several site-neutral payment policies, though the agency did delay or shelve other proposals due to stakeholder feedback.
