Corporate Compliance

Other issuances: CMS issues preliminary decisions on recommendations of outpatient payment panel on supervision levels for select services and more

Medicare Insider, October 2, 2012

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CMS issues preliminary decisions on recommendations of outpatient payment panel on supervision levels for select services

On September 24, CMS posted information on the hospital outpatient payment panel regarding the appropriate supervision levels for individual hospital outpatient therapeutic services. To view the panel’s decisions and recommendations, visit the link below.

http://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/Downloads/Prelim-Supervision-Decisions092412.pdf

CMS issues October 2012 NCD Coding Policy Manual and Change Report

CMS released the October 2012 Medicare National Coverage Determinations (NCD) Coding and Policy Manual and Change Report for clinical diagnostic laboratory services.

View the report.
 
OIG issues Medicare compliance review of Puerto Rico hospital
 
On September 25, the OIG issued a review of Centro Cardiovascular de Puerto Rico y del Caribe (Cardiovascular) in San Juan, Puerto Rico. The review found that 14 of the 171 claims reviewed did not fully company with Medicare billing requirements, resulting in overpayments totaling $72,000.
 
View the OIG report.

OIG issues a review of outpatient billing for selected drugs in Minnesota

On September 25, the OIG issued a review of Medicare outpatient billing for selected drugs at Essential Health Duluth in Duluth, Minn. For 87 of the 131 line items reviewed, Essentia Health Duluth did not bill Medicare for injections of selected drugs in accordance with Federal requirements, resulting in overpayments totaling $865,000.

View the OIG report.

CMS revises guidance on survey protocol for long-term care facilities

On September 27, CMS issued a certification letter which announces revises to Appendix P of the State Operations Manual concerning survey protocol for LTC facilities and chapter 9/exhibits including survey forms 672, 802, 802S, and 820P.

View the letter.

CMS revises guidance on advance directives

On September 27, CMS issued a certification letter which announces that revisions have been made to guidance to surveyors at F tag 155 in Appendix PP of the State Operations Manual to include resident’s rights to establish advance directives and to accept or decline treatments.

View the letter.

CMS revises guidance on quality of care

On September 27, CMS issued a certification letter which announces that revisions have been made to guidance to surveyors at F tag 309 in Appendix PP of the State Operations Manual concerning quality of care/end of life.

View the letter.

CMS revises guidance on feeding tubes

On September 27, CMS issued a certification letter which announces that revisions have been made to guidance to surveyors at F tag 322 in Appendix PP of the State Operations Manual concerning feeding tubes.

View the letter.  

CMS issues guidance on reducing avoidable hospitalizations among nursing facility residents

On September 27, CMS issued a fact sheet and press release both of which detailed the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents in which CMS is partnering with seven organizations to implement strategies to reduce avoidable hospitalizations for Medicare-Medicaid enrollees who are long-stay residents of nursing facilities.

View the fact sheet.

View the press release.

CMS issues NCD for transcatheter aortic valve replacement (TAVR)

On September 25, CMS issued a national coverage determination for transcatheter aortic valve replacement (TAVR).

View the NCD.

 



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