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!
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.
Let's look at one specific area where case managers can make a difference: reducing hospital-acquired anemia (HAA). This condition is often the result of blood draws performed cumulatively—and sometimes excessively—as part of laboratory testing.The prevalence of HAA can be exacerbated by another form of inappropriate medical care—in this case, laboratory tests. The goal is to ensure a patient only undergoes laboratory tests he or she truly needs.
