Medicare Compliance & Reimbursement

Program Transmittal Roundup

The HHS Office of Inspector General and the Centers for Medicare & Medicaid Services have been hounding hospitals to beef up compliance on patient status codes for patients who are discharged to post-acute settings. And according to a recent program transmittal (change request 3240), hospitals can soon look forward to word from their fiscal intermediaries that changing a patient status code to indicate a transfer won't get them into hot water with the OIG, even if the change doesn't jibe with the hospital's medical records.
 
The transmittal says CMS will soon issue a related article on its Web site at
www.cms.hhs.gov/medlearn/matters.

In other recent program transmittals, CMS:

  • lays out updated transitional outpatient payment policies under the outpatient prospective payment system (CR 3214);
  • updates the healthcare provider taxonomy codes (CR 3188);
  • announces the latest version of the provider statistical and reimbursement reporting system (CR 3182);
  • notes that there will be no update to the laboratory national coverage determination edit module for July 2004 (CR 3210); and
  • issues the latest quarterly update to the skilled nursing facility no-pay file (CR 3238).

    To see the program transmittals, go to
    http://cms.hhs.gov/manuals/transmittals/comm_date_dsc.asp.
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