CMS is looking to reduce reporting and documentation requirements for inpatient rehabilitation facilities (IRF) in the 2019 IRF payment system proposed rule, published in the Federal Register May 8. The proposed changes could come as a relief to IRFs that have seen a significant uptick in audits and denials.
Success under MACRA relies on the capture and maintenance of trustworthy clinical and financial patient data sets. HIM professionals understand root cause analysis, the mechanism of reporting data, and the importance of data consistency and integrity.
CMS recently clarified the use of modifier -KX (requirements specified in the medical policy have been met) in response to an Office of Inspector General report that identified conflicting guidance that resulted in $4.6 million in improper payments.
The OIG will be scrutinizing how CMS collects overpayments, according to a recent update to its Work Plan. The agency will be looking at whether CMS followed recommendations to improve and increase collections.
