This week in Medicare updates–4/5/2017
Information to Assist Providers and Suppliers in Meeting the New Training and Testing Requirements of the Emergency Preparedness Requirements for Medicare & Medicaid Participating Providers and Suppliers Final Rule
On March 24, CMS posted a Memorandum providing information to assist providers and suppliers in meeting the training and testing requirements of the new Emergency Preparedness Final Rule, published September 16, 2016 (81 FR 63860). CMS posted a second related Memorandum with Save the Date information for a Medicare Learning Network National Provider Call on the Emergency Preparedness Requirements for Medicare & Medicaid Participating Providers and Suppliers Final Rule. The call will be held April 27.
Measuring Compliance Program Effectiveness: A Resource Guide
On March 27, the OIG published a Resource Guide based on a January 2017 meeting between the OIG and a group of compliance professionals, the goal of which was to discuss ways to measure compliance program effectiveness. The resulting publication, Measuring Compliance Program Effectiveness: A Resource Guide, provides measurement options for a wide range of organizations with diverse size, operational complexity, industry sectors, resources, and compliance programs.
Medicare Compliance Review of Jackson-Madison County General Hospital for Claims Paid From June 1, 2013, Through May 31, 2015
On March 28, the OIG published a Report regarding its review of Jackson-Madison County General Hospital for Claims Paid From June 1, 2013, through May 31, 2015. The OIG found that the hospital did not fully comply with Medicare billing requirements for 59 out of 200 claims it reviewed, resulting in net overpayments of approximately $189,000. Based on the sample, the OIG estimates the hospital received overpayments of at least $1.4 million for the audit period.
Renewal of Advance Beneficiary Notice of Noncoverage, Form CMS-R-131
On March 28, CMS posted an announcement regarding the renewal of the ABN, Form CMS-R-131, by the Office of Management and Budget (OMB). Providers should note the new expiration date on the form, though there are no changes to the form itself.
Effective date: June 21, 2017
Clinical Laboratory Data Reporting: Enforcement Discretion
On March 30, CMS announced that it will exercise enforcement discretion until May 30, 2017, regarding the data-reporting period for reporting applicable information under the Clinical Laboratory Fee Schedule and the application of the Secretary’s potential assessment of civil monetary penalties for failure to report applicable information. This discretion applies to entities that are subject to the data reporting requirements adopted in the Medicare Clinical Diagnostic Laboratory Tests Payment System final rule published on June 23, 2016 (81 FR 41036).
New Waived Tests
On March 30, CMS published Transmittal 3741, which rescinds and replaces Transmittal 3696, dated January 20, 2017, to change the incorrect CPT drug test code from 80305 to 80305QW in the attachment.
Effective date: April 1, 2017
Implementation date: April 3, 2017
Memorandum on Final Rule Adjusting Civil Monetary Penalties (CMP) for Inflation
On March 31, CMS posted a Memorandum regarding the February 3, 2017, final rule adjusting CMP amounts for inflation. The Memorandum highlights the CMPs assessed for skilled nursing facilities, nursing facilities, home health agencies, and clinical laboratories effective February 3, 2017.
Effective date: February 3, 2017