In recent years, the Office of Inspector General (OIG) has taken aim at case managers and discharge planners who violated federal anti-kickback statutes—specifically those who took items or payments in exchange for post-acute referrals.
A physician advisor (PA) can be a powerful ally for case managers. Organizations should be certain to take full advantage of what this role can offer by structuring the position properly.
A report released last month by the American Hospital Association (AHA), called Commercial Health Plans’ Policies Compromise Patient Safety and Raise Costs, found that not only is the cost of private health insurance raising affordability issues for American consumers, but policies, such as prior authorization requirements, may increasingly be putting patients at risk and driving up hospital administrative costs.
CMS issued the final rules for the 2023 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) on August 1 and, like the proposed 2023 OPPS proposed rule, there aren’t any big surprises this year.
The 2023 OPPS proposed rule is out, and it includes some minor changes to the inpatient-only list and a proposal for a new type of hospital. CMS will now host a public comment period through September 13 before finalizing the rule in early November.
The case manager shortage is a national crisis, affecting care coordination from hospital to community. Patients, families, and children are feeling the impact.
Not all hospital-level care needs to take place in a hospital. Since it was first announced in November 2020, CMS’ Acute Hospital Care at Home waiver program has allowed organizations to provide acute care to qualifying patients in their homes rather than in the traditional setting.
Telehealth coverage may be changing in your state as early as this fall—if it hasn’t already. While Medicare has pledged to cover telehealth services through December 2023, many state public health emergency waivers that expanded telehealth services are set to be rolled back.
