This week’s Medicare updates include a Special Edition MLN Matters article on diabetes screening tests, revisions to the ambulatory surgical center October payment system update, manual changes related to implementation of the SNF Patient Driven Payment Model, and more!
CMS’ proposal in the 2020 OPPS proposed rule mandating the disclosure of negotiated charges between hospitals and payers may exceed the agency’s legal authority, the American Hospital Association (AHA) stated in its comments on the proposed rule.
This week’s Medicare updates include a final rule on revisions to discharge planning requirements, a handful of resources regarding a fraudulent genetic testing scheme, revisions to quality policies and procedures for laboratories, and more!
Managers should not assume that they can review every guideline, every item in Coding Clinic, or every coding-related issue targeted by the OIG or Recovery Auditors. However, those issues that have been identified as the result of denials, external coding audits, or quality initiatives should surface to the top of the audit list for the coding manager.
As Medicare Advantage makes strides to becoming the new norm, organizations need to establish new processes, educate staff, and advocate for patients. Learn how your organization can keep pace with change before it’s too late to catch up.
Q: A payer has begun denying authorization for admissions and diverting patients from our hospital to one of our competitors, even when our hospital is closer. Is this a common practice among payers? What language should we add to the contract to discourage it?
