Medicare Compliance & Reimbursement
Avoid IPPS Incidents By Asking Questions
Hospitals must know if doctor prescribed aspirin to heart attack patients. Tracking Quality Data Vital To IPPS Compliance Facilities that hold off on submitting their quality information could lose a 0.4 percent payment increase. Acute care hospitals that report their quality data will score a 3.7 percent rate increase for inpatient services, while those that don't can only earn a 3.3 percent increase. For patients with heart failure, these are the questions hospitals need to answer and submit in order to stay compliant with the IPPS rules changes: And for pneumonia patients, hospitals need to answer the following questions:
August's inpatient prospective payment system final rule delivered a bundle of changes to the way a hospital must do business, and facilities that have not implemented the new changes yet could be losing reimbursement.
Further, facilities that aren't up on the IPPS switches also risk being out of line with current compliance measures, which could bring auditors around.
To stay current with the latest IPPS rule tweak, hospitals should have made the following changes:
To secure the full payment for 2006, hospitals will need to send in their clinical data on these quality measures regarding treatment of patients suffering heart attacks:
• Did the patient receive aspirin upon his arrival at the facility?
• Did the physician prescribe the patient aspirin upon discharge?
• Did the patient receive a beta-blocker upon arrival at the facility?
• Did the physician prescribe a beta-blocker when the patient was discharged?
• Did the patient receive an ACE inhibitor?
• Did the physician assess the patient's heart function?
• Did the patient receive an ACE inhibitor?
• Did the patient receive an antibiotic in a timely manner?
• Had the patient previously received a pneumococcal vaccination?
• Did the doctor assess the patient's oxygen level?
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Avoid IPPS Incidents By Asking Questions
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