The Medicare Outpatient Observation Notice is back and your organization should be ready to use it to comply with the NOTICE Act no later than March 8, roughly 90 days from the December 7 final approval of the form by CMS.
This week’s Medicare updates include finalization of two new payment models, the January 2017 update of the ASC Payment System, an OIG report on vulnerabilities that remain under CMS' 2-Midnight Rule, and more!
Every couple months, it seems questions arise about the 2-midnight rule and there are rumors that it may be going away. Below are some questions with answers from our expert Ronald Hirsch, MD, FACP, CHCQM, vice president of the Regulations and Education Group at Accretive Health in Chicago, to clarify where things stand today with regard to the 2-midnight rule.
Hospitals were struggling this summer to comply with the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act, which was signed by President Barack Obama August 6, requiring hospitals to provide a verbal and written notice of outpatient status to any patient in observation who has been in the hospital for more than 24 hours.
Observation hours start accruing not when the patient comes into the hospital, but when the physician writes the order for observation. Observation hours end when all medically neces¬sary services related to observation are complete.
It's no secret that hospitals struggle with assigning the most appropriate status for patients, and this challenge is compounded by CMS' frequent changes to its regulations and guidance. To combat incorrect patient status assignments, one hospital has developed a system that rewards employees for speaking up when they suspect a patient's status is incorrect.
Observation services are an ongoing point of confusion for hospitals and patients, many of whom have become fearful of out-of-pocket costs and SNF coverage eligibility associated with outpatient observation services. Developing a workflow to comply with the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act and the Medicare Outpatient Observation Notice (MOON) is essential and is intended to help hospitals ease patients' concerns by clearing up the implications of observation.
What do you do with a patient who does not have a safe discharge plan, but does not meet inpatient criteria and has been in observation status for 48 hours?
This week’s updates include the temporary pause of QIO short stay reviews; review of CMS' Pioneer Accountable Care Organization Payment Model first performance year administration; and more!