Along with its annual updates to the inpatient-only list, the 2020 Outpatient Prospective Payment System (OPPS) final rule finalized a proposal that will give hospitals a grace period to adjust internal policies for procedures recently removed from the inpatient-only list.
As of October 1, approximately 1,080 cases of respiratory illnesses and 18 deaths brought on by vaping have been reported in the U.S., according to the U.S. Centers for Disease Control and Prevention (CDC). Despite continued research into these cases by the CDC and the U.S. Food and Drug Administration (FDA), the specific cause of these illnesses remains unknown.
This week’s Medicare updates include the Outpatient Prospective Payment System final rule, the Medicare Physician Fee Schedule final rule, a proposed decision memo on genetic testing for cancer, and more!
Q: How should we handle denied claims when the payer refuses payment under the billed status? Do we need to document that the status was changed only because the payer did not agree to any other options?
CMS is moving forward with multiple policies—effectively based on reducing reimbursement to hospitals—that have been deemed unlawful in court, according to the 2020 OPPS final rule, released Friday, November 1. However, the agency pushed its controversial price transparency proposals to a separate, yet-to-be released final rule.
