News

CMS’ 2019 OPPS proposed rule continues the agency’s efforts to enforce site-neutral payments and reduce drug payments by introducing policies to reduce reimbursement for hospital outpatient clinic visits at off-campus, provider-based departments (PBD) and expanding last year’s payment reductions for drugs purchased under the 340B discount pricing program by nonexcepted PBDs.

Q: If an employee of our facility is seen for a routine vaccine, is it permissible for the nurse to review the patient history?

CMS would use the proposed modifiers to implement a 15% payment reduction starting in 2022 for services provided in whole or in part by physical therapy assistants (PTA) and occupational therapy assistants (OTA).

The Commission for Case Manager Certification announced that its recently selected 2018–2019 officers will focus on the professional development of case managers and disability specialists.

What can case managers do to advocate for patients who are in need of financial assistance?

What strategies should hospitals follow for deciding whether to appeal denied claims and submitting appeal letters?

Q: In ICD-10-CM, how would you report a patient who is receiving hemodialysis and has chronic kidney disease (CKD) when a failed kidney transplant is also documented?

A former Arkansas Children’s Hospital employee is under investigation for misusing patients’ personal health information for personal gain, according to an announcement from the hospital.

Q: Is it a HIPAA violation to receive a postcard from a facility regarding your mammogram, date, time, and instructions?

Q: How can a case manager match a patient with a care plan and help the patient meet planned goals?