This week's note from the instructor discusses some frequently asked questions and resources related to provider-based departments, including off-campus departments.
Reimbursement for provider-based departments (PBD) can be complex, and regulations affecting it have changed frequently over the past year. Section 603 of the Bipartisan Budget Act of 2015, the 2017 outpatient prospective payment system (OPPS) final rule, and the 21st Century Cures Act changed the payment methodology and made multiple adjustments to the definition of excepted (on-campus or grandfathered off-campus) and non-excepted (off-campus) PBDs. Hospitals must know the regulations inside and out and understand how they apply to their PBDs and to avoid denials or noncompliance.
This week’s Medicare updates include new CLIA waved tests, changes to the payment policies for Reciprocal Billing Arrangements and Fee-For-Time Compensation Arrangements (formerly “Locum Tenens Arrangements”), implementation of modifier -CG for Type of Bill 72x, and more!
Patients who participate in accountable care organizations (ACO) and care management teams may have fewer hospitalizations and ED visits and lower Medicare spending, according to a recent study in Health Affairs. Care management is a cornerstone of ACO interventions.
Compiling the statistics for insider threats to patient privacy is easy. It’s the mitigation of these risks that takes time, strategy, and commitment. According to the January 2017 Protenus Breach Barometer, internal health system employees were responsible for 58.4% of breached patient data during January 2017.
