News You Can Use: Prepare for Revamped Conditions of Medicare Participation

· Find out how CMS has changed your CoPs

Starting on Sept. 19, 2005, prescribing a patient’s diet is the practitioner’s responsibility--not the consulting dietitian’s. CMS notified its state survey agency directors in an Aug. 18 letter that it has revised and clarified the Medicare hospital conditions of participation (CoP).
What to expect: CMS clarifies the patient grievance process, revises the definition of grievance and clarifies the written response requirements. Other changes to the Medicare CoPs include:

· In states that permit midwives to admit patients to the hospital, their Medicare patients must receive care from a doctor of medicine or osteopathy. The agency doesn’t require this for a midwife’s Medicaid or other non-Medicare patients, however.

· Hospitals must provide on-site emergency laboratory services 24 hours per day, seven days per week. Multi-campus hospitals must have these services available on-site at each campus.

· The practitioner responsible for a patient’s care must prescribe his diet, even when a dietitian provides recommendations or consultations for the patient.
 
To read the letter, go to www.cms.hhs.gov/medicaid/survey-cert/sc0542.pdf.
· You can’t convert part of your hospital to a CAH

CMS won’t approve your critical access hospital (CAH) application for a facility that is only a portion of a multi-location hospital.
Hospitals with more than one geographic location or campus cannot convert one of their locations to a CAH status, CMS said in an Aug. 18 letter to its state survey agency directors. CMS won’t allow you to convert part of your hospital to a CAH while the remainder of your facility continues to bill claims under your existing acute care hospital provider number.
 
Reason: Regulations require a facility “that converts to a CAH to be a hospital in its own right prior to conversion to a CAH,” CMS says. If you want to become a CAH, you must terminate your hospital’s provider agreement and convert your entire facility to CAH status, the agency says.
To read the letter, go to www.cms.hhs.gov/medicaid/survey-cert/sc0540.pdf.
 
· CMS tries to clear up screening code confusion

Even though you can get Medicare reimbursement for prostate cancer screenings, CMS is still flip-flopping on what code you should use to report it.
Why: When CMS decided to allow Medicare coverage for prostate cancer screening, it neglected to remove ICD-9 code V76.44 (Special screening for malignant neoplasms of the prostate) from the list of noncovered codes, according to a tracking sheet it posted on its Web site Aug. 9. Now CMS wants public comments on whether it should remove V76.44 from the list of noncovered codes.
The agency opened the issue for comment on Aug. 9 and it has already received substantial feedback. Public comments were mixed regarding the code [...]

- Published on 2005-09-21