News & Analysis

July 28, 2017
Case Management Monthly

In recent years, the federal government has been pushing hospitals to help their patients self-manage chronic conditions. If patients and families aren’t able to sufficiently self-manage their conditions within 30 days of discharge, hospitals may incur reimbursement penalties when these patients are readmitted or need to come back to the emergency department, says Karen Zander, RN, MS, CMAC, FAAN, president and CEO of The Center for Case Management, Inc., in Wellesley, Massachusetts.

July 21, 2017
Case Management Monthly

Below is information from the National Institute of Mental Health outlining the signs and symptoms of depression and how the condition might manifest differently in different patients. The complete guide on depression is available online.

May 24, 2017
Medicare Insider

This week's note discusses the order and certification requirement for critical access hospitals (CAH), including the proposal in the FY 2018 IPPS proposed rule to reprioritize the review of CAH inpatient admissions.

April 7, 2017
Case Management Monthly

Just before the MOON requirement became effective March 8, CMS added another hoop to jump through in an open door forum held February 28.The discussion in that forum forced many organizations to change course at the last minute as CMS announced it would not allow pre-populated check boxes in the free-text field of the MOON designated for describing clinical reasons for the service the patient receives. Organizations that had listened to experts touting the value of adding check boxes with specific rationale to the MOON were forced to revamp the form shortly before implementation.

April 4, 2017
Medicare Insider

This week's note from the instructor discusses several changes regarding inpatient-only procedures that might have flown under the radar for some hospitals.

March 31, 2017
Medicare Web

Do we give a MOON letter to a patient who was originally assigned to inpatient status, but then reassigned to observation services when the utilization review committee determined that he or she did not meet inpatient criteria. In this instance, condition code 44 was used and the patient’s status was changed to observation. If we are required to deliver the MOON form in this situation, should it be given to the patient at the same time as the patient is given information on condition code 44?