Medicare Compliance & Reimbursement
Watch Out for Regulatory and Compliance Hot Spots
Will your documentation pass muster?
The Centers for Medicare & Medicaid Services (CMS) outlines plans for some big changes in the proposed rule for 2017 hospice payment. Chief among them are new quality measures and a new OASIS-like assessment tool.
Good news: Some of the big hospice data points CMS and its contractors are tracking have gone down, points out Judi Lund Person with the National Hospice & Palliative Care Organization. For example, these figures have all decreased: percentage of claims with only one diagnosis; non-hospice spending for hospice patients; Part D spending on drugs for hospice patients; and live discharges.
Bad news: But it appears to be too little, too late. CMS spends a big chunk of the proposed rule outlining its concerns with various areas and warning hospices that it will be monitoring the data and planning related action.
“The greatest risk for hospice agencies … is not necessarily one of the proposals in the rule, but rather the warnings from CMS that it suspects certain hospice providers of engaging in widespread fraudulent activity,” says RN Beth Noyce with Noyce Consulting in Salt Lake City.
Watch out: Providers whose data sticks out in CMS’s areas of concern will most likely “eventually face provider-specific reviews,” Noyce expects. “My concern is that much hospice clinical documentation may not pass muster under medical review.”
Medicare Compliance & Reimbursement
- MACRA:
Next Step: Meaningful Use Out, New Program in -- What You Need to Know
Advancing Care Information eliminates the ineffective ‘one-size-fits-all’ approach. Remember all that buzz earlier this year [...] - Advancing Care Information:
How to Earn Maximum Points in the MIPS Scoring System
You must report a ‘yes’ attestation for patient data security. As the Meaningful Use program [...] - MACRA:
HHS Introduces Two Different Payment Models
Industry expects changes will usher in a new era of excellence and innovation in medicine. [...] - Annual Wellness Visits:
Get This Confusing Coding Scenario Clarified
he key is to demonstrate the separate nature of the additional E/M service, says Palmetto. [...] - Healthcare IT:
Make Healthcare Technology More Accessible
Proposed rule aims to reinvigorate medical technology. The Department of Health and Human Services’ (HHS) [...] - Compliance:
Know When the 60-Day Clock Starts Ticking
You’re responsible for determining whether you’ve received overpayments, says CMS. If you’ve been struggling to [...] - Hospice:
Watch Out for Regulatory and Compliance Hot Spots
Will your documentation pass muster? The Centers for Medicare & Medicaid Services (CMS) outlines plans [...] - Industry Note:
HHS Aims to Revamp CHIP And Medicaid
In an effort to provide greater clarity and responsibility while offering superior managed care in [...] - Industry Note:
CMS Wants You to Use JW Modifier
Mark your calendars for July 1, 2016 — on this date, the new Centers for [...]
