News & Analysis

February 4, 2014
Medicare Insider

On January 31, CMS announced on its Inpatient Hospital Reviews website that it extended the probe and educate period for implementation of the 2-midnight benchmark through September 30, 2014. Along with the announcement of the extension, it also released an updated version of the guidance documents on inpatient hospital reviews and on the new order and certification requirements. Click the link above for more information and an in-depth analysis.

January 28, 2014
Medicare Insider

In this week’s note, we will take a closer look at RUN transmittal R2845CP and related MLN Matters Article MM8572. Click the link above for more information and an in-depth analysis.

January 21, 2014
Medicare Insider

Last week, CMS released MLN Matters article MM8572 with billing instructions for laboratory services paid under either OPPS or the Clinical Laboratory Fee Schedule (CLFS). Prior to this guidance, I had received several questions from clients and past students regarding rural sole community hospital (SCH) add-on payments for lab services. Click the link above for more information and an in-depth analysis.

January 14, 2014
Medicare Insider

As we await more instructions from CMS on implementation of the OPPS and MPFS final rule, I thought I would take this time to let those who missed the CMS notice know that they will be hosting another National Provider Call on Tuesday, January 14th from 1:30 to 3:00 p.m. EST.Click the link above for more information and an in-depth analysis.

January 8, 2014
Medicare Insider

In the OPPS proposed rule, CMS had proposed to do away with the device to procedure and procedure to device edits. While this may seem like a provider friendly change, in fact, these edits have ensured that all costs, including the costs of all devices used, are billed by providers. This in turn ensures they are taken into account in rate setting, because CMS uses providers’ billed charges as a proxy for cost in setting future rates. Click the link above for more information and an in-depth analysis.

January 2, 2014
Medicare Insider

CMS issues certain quarterly updates relating to hospital outpatient services.These updates are primarily issued in the form of two recurring update notification transmittals (RUN).The first of these is a quarterly update to the IOCE Specifications. The second is a quarterly update to the Outpatient Prospective Payment System (OPPS). Because the most significant outpatient hospital changes become effective as of the beginning of each calendar year, the January updates are particularly important.Click the link above for more information and an in-depth analysis.

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