In October 2014 a record number of hospitals were fined for excessive care transitions. In total, CMS penalized some 2,610 hospitals, and will assess fines between October 2014 and September of this year. Through these penalties, the government has given hospitals sufficient incentive to revamp their processes with an eye on preventing readmissions and improving transitions.
The good news is that the rate of 30-day readmissions is going down in hospitals across the nation, according to a CMS report. The bad news is that fines are going up. CMS also added some new conditions to its readmission prevention list for 2015.
The implementation of Comprehensive APCs (C-APCs) in the 2015 OPPS final rule likely wasn't a huge surprise to most providers, given CMS discussed this concept in the 2014 final rule and indicated it expected to implement it the following year.
While organizations should focus on performing regular risk assessments and analyses, there are also other ways in which they must review their systems for compliance. Often, these other evaluations are overlooked despite their value, says Kevin Beaver, CISSP, an information security consultant in Atlanta. In particular, organizations should be careful not to forget about performing vulnerability assessments and penetration tests, which are components of an overall risk assessment or analysis, says Beaver, who is an editorial advisory board member for SHCC's sister publication Briefings on HIPAA.
Inpatient coding professionals are used to DRG systems where all of the diagnoses and procedures map to a single DRG. So they may not look for additional procedures and services to report outside of that DRG.
