We found out after an observation patient was discharged that one of the procedures performed was an inpatient-only procedure. Can we bill this to Medicare without an official inpatient order on the medical record?
CMS is moving forward with its plan to drastically cut payments for drugs acquired through the 340B drug discount program, according to the 2018 OPPS final rule, released in November.
Mary, an experienced nurse case manager, has worked on her medical unit for five years. She likes her assignment because it is never boring; she services a wide variety of patients with complex medical problems, and she feels satisfyingly challenged by the intricacies of each case. This is why, when the unit’s nurse manager approaches Mary about transferring a patient to another acute care setting with only a few hours’ leeway, Mary believes she can make it happen.
CMS’ policy in the 2018 OPPS final rule to cut reimbursement for drugs purchased through the 340B drug discount program by nearly 30%, accounting for the decrease from average sales price plus 6% to minus 22.5%, is getting a lot of attention from the provider community—and with good reason.
