This April, CMS made a switch, changing the volume of charts allowed for Quality Improvement Organization (QIO) short-stay audits. Prior to this change, the number of charts selected for audit ranged from 10 charts for small hospitals to 25 charts for larger hospitals. Now, the 175 hospitals with the highest volume of short stays will have 25 charts audited, while hospitals with a “Major Concern” rating on a previous audit will receive a request for 10 charts.
Rush University Medical Center in Chicago did not comply with Medicare billing requirements for 57 inpatient and outpatient claims reviewed by the OIG, according to the OIG’s November report. This resulted in unlawful reimbursement for calendar years 2014 and 2015 with the medical center receiving $814,150 in overpayments, says the report.
This week’s Medicare updates include an advisory opinion on using network hospitals for inpatient stays; annual updates to HCPCS codes used for home health consolidated billing and the therapy code list; the removal of hyperbaric oxygen therapy (topical application of oxygen) from an NCD; and more!
Participation in the Supplemental Nutrition Assistance Program can lead to decreased healthcare claims and out-of-pocket costs for low-income adults, according to a JAMA Internal Medicine study.
