Inpatient Facility Coding & Compliance Alert

Hint: The clock is ticking for being part of the EHR Incentive Program.

CMS is still assessing how the partial government shutdown will impact its completion of the calendar year 2014 Medicare fee for service payment regulations. The agency still plans to issue the final rules on or before Nov. 27, 2013, however, with most going into effect on Jan. 1, 2014.

The impacted regulations from a hospital perspective include:

• Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (CMS-1526-F)
• CY 2014 Changes to the Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System (CMS-1601-FC)
• CY 2014 Home Health Prospective Payment System Final Rule (CMS-1450-F)
• Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2014 Final Rule with Comment Period (CMS-1600-FC)

Because of the late issuance of the payment system Federal Register entries, all healthcare providers will have a shortened window to prepare for January 1, 2014 implementation. Keep a close eye on future issues of Inpatient Facility Coding and Compliance Alert for updates as they become available.

Finalize Your EHR Incentive Program Registration

The countdown has begun for hospitals to participate in the 2013 EHR Incentive Program.

The last day that eligible hospitals and critical access hospitals (CAHs) can register and submit attestation in for the FY 2013 Medicare EHR Incentive Program is November 30, 2013, according to CMS announcements. Eligible hospitals and CAHs must successfully attest to demonstrating meaningful use by November 30 to receive a 2013 incentive payment. Eligible professionals and hospitals can receive payments of up to $44,000.00 for Medicare and up to $67,350.00 for Medicaid.

Timing: Hospitals must attest to demonstrating meaningful use every year to receive an incentive and avoid a negative payment adjustment. Hospitals should refer to their state deadlines for attestation (found at http://www.cms.gov/apps/files/statecontacts.pdf).

Consequence: CMS will apply payment adjustments to Medicare eligible hospitals that have not successfully demonstrated meaningful use. The adjustment is determined by the hospital’s reporting period in a prior year, and will be applied beginning FY 2015 (October 1, 2014).

Double Check Corrected IPPS Prices

The FY 2012 Inpatient Prospective Payment System (PPS) PC Pricer experienced issues with pricing transfer claims. The corrected version is now available on the Inpatient PPS Pricer web page from CMS, in the “Downloads” section.