This week in Medicare updates–02/24/2016
CAH Recertification Checklist for evaluation of compliance with the location and distance requirements
On February 12, CMS posted a survey and certification letter to aid in routinely re-evaluating the compliance of currently certified CAHs with the status and location requirements at 42 CFR 485.610. CMS has revised the attached CAH Recertification Checklist: Rural and Distance or Necessary Provider Verification for use by the CMS regional office staff when processing CAH recertifications. The revised checklist includes procedures on determining whether a CAH that was certified by CMS prior to January 1, 2006, had been designated by the state as a necessary provider, and examples of documentary evidence to demonstrate necessary provider designation prior to January 1, 2006.
View the survey and certification letter.
Core quality measures collaborative release
On February 16, CMS announced that, for the last three years, it has worked to align quality measures across public programs in order to support consistent high quality care for patients and reduce complexity and burden for clinicians in how they report on quality improvements. For example, CMS has aligned quality measures across acute care hospital programs, such as the Inpatient Quality Reporting Program, Hospital Value Based Purchasing, and the Hospital-Acquired Condition Reduction Program. Hospitals report quality measures once, which are then used for these multiple programs. In support of these efforts, CMS, in collaboration with America’s Health Insurance Plans, released seven sets of clinical quality measures designed to support multi-payer alignment.
View the fact sheet.
View the press release.
Privacy Act of 1974; CMS Computer Match No. 2016-10; HHS Computer Match No. 1607
On February 17, CMS posted a notice in the Federal Register stating that, in accordance with the requirements of the Privacy Act of 1974, as amended, it is announcing the re-establishment of a Computer Matching Program (CMP) that CMS plans to conduct with the Department of Homeland Security, United States Citizenship and Immigration Services. On the same date, CMS posted a notice announcing the re-establishment of a CMP that CMS plans to conduct with the IRS. The effective date is April 2, and the expiration date is October 2.
View the DHS notice in the Federal Register.
View the IRS notice in the Federal Register.
Proposed Collection; Comment Request
On February 19, CMS posted a notice in the Federal Register stating that it is accepting comments on: CMS–484, Attending Physician’s Certification of Medical Necessity for Home Oxygen Therapy and Supporting Regulations; CMS–846–849, 854, 10125 and 10126, Durable Medical Equipment Medicare Administrative Contractors (MAC) Regional Carrier, Certificate of Medical Necessity and Supporting Documentation; CMS–10379, Rate Increase Disclosure and Review Reporting Requirements; CMS–10418, Medical Loss Ratio Annual Reports, MLR Notices, and Recordkeeping Requirements. Comments are due April 19.
View the notice in the Federal Register.
Leave a comment.
Danbury Hospital reported overstated wage data resulting in Medicare overpayments
On February 19, the OIG posted a report stating Danbury Hospital, located in Danbury, Connecticut, did not always comply with Medicare requirements for reporting wage data in its FY 2010 Medicare cost report. Specifically, the hospital reported overstated wage data totaling $4.9 million and 10,000 hours, which affected the numerator and denominator of its wage rate calculation. These errors occurred because the hospital did not sufficiently review and reconcile the data to ensure that it was accurate, supportable, and in compliance with Medicare regulations. Because of the errors, the OIG estimated that in FY 2014 Medicare overpaid the hospital approximately $249,000 and overpaid five other hospitals in the same core-based statistical area a total of approximately $741,000.