This week in Medicare updates – 10/14/2015
Changes to the laboratory NCD edit software for January 2016
On October 2, CMS released a transmittal announcing the changes that will be included in the January 2016 quarterly release of the edit module for clinical diagnostic laboratory services.
Effective date: January 1, 2016
Implementation date: January 4, 2016
View Transmittal R3366CP.
View MLN Matters article MM9352.
Signature requirements
On October 2, CMS released a change request to allow contractors to accept initials instead of signatures for amendments or delayed entries in medical record entries, if there is evidence in the medical record associating the provider's initials with their name.
Effective date: October 1, 2015 process date
Implementation date: November 2, 2015
View Transmittal R615PI.
ICD-10 conversion/coding infrastructure revisions to NCDs—third maintenance change request
On October 5, CMS rescinded Transmittal 1537, dated September 21, 2015, and replaced it with Transmittal 1547 to add a separate CWF action to the implementation date. All other information remains the same. The original transmittal was the third maintenance update of ICD-10 conversions/updates specific to NCDs.
Effective date: October 1, 2015
Implementation date: January 4, 2016, with the following exceptions
View Transmittal R1547OTN.
View MLN Matters article MM9252.
Correction to IPPS for acute care hospitals and the long-term care hospital PPS policy changes and FY 2016 rates
On October 5, CMS posted a notice in the Federal Register correcting technical and typographical errors in the final rule and interim final rule with comment period that appeared in the Federal Register on August 17, 2015, “Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Policy Changes and Fiscal Year 2016 Rates; Revisions of Quality Reporting Requirements for Specific Providers, including Changes Related to the Electronic Health Record Incentive Program; Extensions of the Medicare-Dependent, Small Rural Hospital Program and the Low-Volume Payment Adjustment for Hospitals.” This document is effective October 1, 2015.
View the notice in the Federal Register.
Correction of FY 2016 hospice wage index and payment rate update and hospice quality reporting requirements
On October 5, CMS posted a notice in the Federal Register correcting technical errors that appeared in the final rule published in the Federal Register on August 6, 2014, “Medicare Program; FY 2016 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements.” The effective date is October 1.
View the notice in the Federal Register.
Correction to PPS and consolidated billing for SNF for FY 2016, SNF value-based purchasing program, SNF quality reporting program, and staffing data collection
On October 5, CMS posted a notice in the Federal Register correcting technical errors in the final rule that appeared in the Federal Register on August 4, 2015, “Medicare Program; Prospective Payment System and Consolidated Billing for SNFs for FY 2016, SNF Value-Based Purchasing Program, SNF Quality Reporting Program, and Staffing Data Collection.” The effective date is October 1.
View the notice in the Federal Register.
A reminder from the OIG about information blocking and the Federal Anti-Kickback Statute
On October 6, the OIG posted an article on its website regarding National health IT week, and ensuring that health IT is used to achieve patient care and public health and not as a tool to facilitate healthcare fraud.
View the article.
Electronic Health Record Incentive Program and Health IT Certification Program final rules
On October 6, CMS released final rules that simplify requirements and add new flexibilities for providers to make electronic health information available and for healthcare providers and consumers to be able to readily, safely, and securely exchange that information. The final rules for 2015 Edition Health IT Certification Criteria (2015 Edition) and final rules with comment period for the Medicare and Medicaid EHR Incentive Programs will help continue to move the healthcare industry from a paper-based system.
View the fact sheet regarding the final rules.
View the fact sheet about EHR incentive programs.
Applying therapy caps to Maryland hospitals
On October 7, CMS released a change request revising Original Medicare systems to ensure therapy services provided in Maryland hospitals are subject to the outpatient therapy per-beneficiary caps.
Effective date: January 1, 2016
Implementation date: January 4, 2016
View Transmittal R3367CP.
Comprehensive ESRD Care (CEC) Model
On October 7, CMS released a fact sheet that discussed a new accountable care organization model called the CEC Model. Through this new model, CMS will partner with groups of healthcare providers– ESRD Seamless Care Organizations to test and evaluate a new model of payment and care delivery to improve Medicare ESRD beneficiary health outcomes and reduce Medicare spending.
View the fact sheet.
View the press release.