Case Management Monthly

September has always been synonymous with students returning to the classroom. While that may not be reason enough to review the HIPAA Privacy Rule, a more compelling reason to dust off the HIPAA education materials might be the government's increase in enforcement efforts.

When evaluating a family's ability, willingness, and availability to provide needed care to patients, discharge planners may become aware of scenarios that are not reasonable or safe for the patient.

Hospitals may have a higher than expected readmission rate simply because they aren't properly billing cases that should be a leave of absence.

Starting October 2012, Medicare will begin paying hospitals for quality measures, according to a CMS fact sheet released April 29.

Most facilities have a UR committee, but not all organizations have a fully functional UR committee.

An interrupted stay occurs when a patient is discharged from a long-term acute care hospital (LTAC) for treatment and services that are not available in the LTAC and after a specific number of days away from the LTAC, is readmitted to the same LTAC for further medical treatment.

From the Important Message from Medicare to the discharge instructions, case managers juggle a myriad of forms throughout a patient stay. CMS added another form to the list when it implemented the face-to-face encounter requirement for home health referrals.