This week's note reviews two major policy changes from the OPPS and MPFS final rules: the reduction in reimbursement for 340B drugs and the reduction in the payment adjustment for non-excepted off-campus provider-based departments.
This week’s Medicare updates include the OPPS, Quality Payment Program, End-Stage Renal Disease, and Medicare Physician Fee Schedule final rules; an announcement of the new Meaningful Measures initiative; a list of new Clinical Laboratory Improvement Amendments waived tests; and more!
On August 14, CMS published the FY2018 Inpatient Prospective Payment System Final Rule; with it came discussion and a notice in regards to the 96-hour certification requirement for critical access hospitals (CAH).
Connie, the manager of a case management department, was responsible for the patient discharge transportation budget for patients who did not have a ride home from the hospital. Her role covered all medical-surgical units, but not the postacute recovery room (PACU). However, when she received a desperate call from one of the PACU staff nurses, requesting assistance with a patient who did not have a ride home, she agreed to help. Connie viewed her case management department as being service-oriented and inclusive of all patients, even those beyond her assignment.
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.