The new modifier -PO (services, procedures, and/or surgeries furnished at off-campus provider-based outpatient departments [PBD]) and the alternative payment provisions under the Bipartisan Budget Act Section 603 are both related to off-campus PBDs but define "off-campus PBD" slightly differently.
The Social Security Act allows CAHs and other small rural hospitals to enter into “swing bed” agreements with CMS. Under these arrangements, in addition to providing acute inpatient services, such hospitals are permitted to provide extended care services that would normally be furnished in a skilled nursing facility (SNF). When provided under a swing bed arrangement, SNF extended care services are referred to as “swing bed” services. In a swing bed hospital, an inpatient bed may actually swing from one level of care to another (e.g., acute to swing or swing to acute), depending upon a particular patient’s need.
Despite industry pushback and several delays, ICD-10 implementation has, against all odds, gone relatively smoothly for the vast majority of providers, leading CMS to tout its success in a recent blog post from Andy Slavitt, CMS’ acting administrator.
This week’s updates include a technology assessment regarding treatment of degenerative joint disease with hyaluronic acid; a final notice of modification and termination of OIG Advisory Opinion 08-17; and more!
This week’s note is about the new rule establishing a prior authorization program for certain durable medical equipment, prosthetics, orthotics, and supplies.
This week’s updates include the January 2016 update of the hospital OPPS; April 2016 quarterly update for the DME, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP); and more!
Small tweaks to the 2-midnight rule in the 2016 OPPS final rule should help providers, but a lengthy court battle related to the rule could end up making a bad situation worse.
