Corporate Compliance

Note from the instructor: Corrections to OPPS payment rates and OPPS and IPPS wage indices

Medicare Insider, August 21, 2012

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Editor’s note: Judith Kares, JD, CPC, regulatory specialist for HCPro, Inc., is the author of this week’s note from the instructor.

Hospitals need to be aware of changes to OPPS payment rates and IPPS and OPPS wage indices that may impact their payments for OPPS and/or IPPS services during portions of CY 2011, CY 2012 and FY 2012.

In its July quarterly update to the OPPS, CMS reminded hospitals that it had published initial corrections to OPPS payment rates for CY 2012 in the Federal Register on January 4, and additional corrections to CY 2012 OPPS payment rates on April 24, 2012. These corrections, which are retroactive to dates of service on and after January 1, 2012, were fully incorporated into the July 1updates to Addenda A and B of the CY 2012 OPPS Final Rule. The updated addenda can be downloaded from the CMS website. Hospitals should check to see whether payments made for dates of service during the first half of CY 2012 were made in error, based upon these subsequent corrections. If so, CMS has informed hospitals that they must take the initiative and request adjustment of the previously improperly processed claims.

Continue reading Judith’s note at the Medicare Mentor Blog.



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