This week’s note is about the new rule establishing a prior authorization program for certain durable medical equipment, prosthetics, orthotics, and supplies.
This week’s updates include the January 2016 update of the hospital OPPS; April 2016 quarterly update for the DME, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP); and more!
CMS did not change the logic for comprehensive APCs (C-APC) or complexity adjustments in the 2016 OPPS final rule, but did add 10 new C-APCs for 2016 in addition to the 25 established for the first time for 2015.
I first attended a lecture on the "upcoming" ICD-10 changes that were expected in 1991 (when the rest of the world started transitioning). On October 1, 2015, a mere 24 years and countless lectures later, the U.S. finally adopted ICD-10 (via ICD-10-CM and PCS, which are both unique to the U.S. at this time).
A new proposed rule aimed at reducing readmission rates and improving patient care could bring big changes for case management?in some instances requiring hospitals to nearly double the number of full-time case managers they have on staff, say experts.
If you've been working in case management, you already know that your job has gotten a lot more complicated in recent years. The tasks at hand may even be more daunting if you're a department director who is responsible for complying with a host of different mandates that continue to grow by the day.
