Mandatory participation in Medicare bundled payment programs may yield better results, the U.S. Government Accountability Office (GAO) said in a report released January 22.
Thirty-eight hospitals filed a lawsuit against the U.S. Department of Health and Human Services (HHS) on January 18, alleging that that HHS Secretary Alex Azar overstepped his authority when he finalized an OPPS policy that cuts Medicare payment rates to off-campus, provider-based departments (PBD).
Increased access to urgent care centers (UCC) may decrease the number of patients who seek treatment for low-acuity conditions in hospital emergency departments (ED), according to findings from a retrospective study recently published in the American Journal of Emergency Medicine.
Establishing an outpatient CDI program can have substantial benefits. Recently, an outpatient CDI review project demonstrated there were many documentation improvement opportunities at a large family practice/internal medicine physician clinic.
Findings from a computational health informatics study recently published in Medical Care Research and Review suggest that provider connectedness is associated with reduced 30-day readmission rates for heart failure patients following hospital discharge.
CMS ramped up risk-sharing for accountable care organizations (ACO) in a final rule published December 31, 2018. The final rule makes changes to the Medicare Shared Savings Program and will reduce the amount of time ACOs can stay in one-sided risk models.
The 2019 CPT code update includes 19 code additions and three revisions to the cardiovascular section of the CPT Manual. These changes reflect advances in surgical treatment for cardiovascular conditions such as heart failure and aortic stenosis.
CMS released Transmittal 4188 on December 28, adding instructions to Chapter 23 of the Medicare Claims Processing Manual for the accurate interpretation of claim edits and assignment of modifiers -59 (distinct procedural service) and -91 (repeat clinical diagnostic laboratory test) on Medicare Part B claims.
Despite facing potential lawsuits and political opposition, CMS finalized some of its most controversial proposals in the 2019 OPPS final rule by implementing several site-neutral payment policies and 340B drug payment reductions.
