If your hospital resides in one of the 67 metropolitan statistical areas (MSA) required to participate in the Comprehensive Joint Replacement Model (CJR), you will also be required to participate in a new orthopedic payment model called 'SHFFT' (surgical hip and femur fracture treatment) if an August 2 proposed rule is finalized. The impact? The following assigned MS-DRGs will no longer define hospital reimbursement:
Major Joint Replacement or Reattachment of Lower Extremity (MS-DRGs 469, 470)
Hip and Femur Procedures Except Major Joint (MS-DRGs 480, 481, 482)
This week’s Medicare updates include the release of FY 2017 Dialysis Facility Reports and End Stage Renal Disease Core Survey Materials; the Denial of Home Health Payments When Required Patient Assessment Is Not Received; a Quality Payment Program fact sheet, and more!
Just like the lyrics to the popular Gap Band song say, "You dropped a bomb on me… I won't forget it," there are definitely some changes in the 2017 ICD-10-CM Official Guidelines for Coding and Reporting that some of us may wish the Cooperating Parties will forget were ever mentioned.
In a year of high-profile, multimillion dollar settlements for large HIPAA breaches, OCR raised the stakes in a big way—by taking a harder line on small breaches. OCR announced plans to crack down on smaller breaches—those affecting fewer than 500 individuals—in August.
With only 60 days between the OPPS final rule's release and the January 1 implementation date, providers will be ahead of the curve by spending time now and thinking about the processes they may need to review, change, or implement based on what CMS finalizes and the sort of financial impact the final rule is likely to have.
