As we await more instructions from CMS on implementation of the OPPS and MPFS final rule, I thought I would take this time to let those who missed the CMS notice know that they will be hosting another National Provider Call on Tuesday, January 14th from 1:30 to 3:00 p.m. EST.Click the link above for more information and an in-depth analysis.
CMS' 2014 IPPS final rule redefined inpatient admissions when it implemented the 2-midnight rule, which requires a validated physician order, documentation of medical necessity, and the expectation of a stay crossing two or more midnights.
This week’s note is about CMS’ offer to certain hospitals regarding withdrawing appeals for partial payments. Click the link above for more information and an in-depth analysis.
CMS' Conditions of Participation for UR include specific requirements for the composition of the UR committee, specifying that it must be composed of at least two doctors of medicine or osteopathy.
At many hospitals the terms Utilization Management (UM) and Utilization Review (UR) are used interchangeably. Are they the same thing? No, they're not, according to Stefani Daniels, RN, MSNA, ACM, CMAC, and Ronald L. Hirsch, MD, FACP, CHCQM.
Do observation patients belong in their own unit? The answer is debated at many organizations. Some say establishing a separate unit brings numerous advantages, from improved ED throughput to shorter lengths of stay. Others say some facilities may not need one.
Case managers rejoice. CMS recently sounded what is being called the death knell of the 2-midnight rule certification in a final rule published in the November 10, 2014, Federal Register.
