Corporate Compliance

Note from Hugh

Medicare Insider, June 5, 2007

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Hospitals should carefully review the July 2007 OPPS update transmittal discussed below. This transmittal includes numerous OPPS coding, billing, and payment changes. The changes relating to drugs, devices, and brachytherapy are particularly significant and will require most hospitals to make chargemaster changes.

Also, I have two additional items to report this week relating to the CMS Open Door Forum (ODF) conference calls. First, CMS held a special ODF call on May 29 to discuss the revised "Important Message from Medicare" and the revised "Detailed Notice of Discharge." According to CMS, they had an amazing 4,950 callers on the line for this special ODF call. The changes are very significant. Among other changes, CMS is eliminating the well established "continuing stay" Hospital Issued Notice of Noncoverage (HINN) forms. Between now and the July 1 effective date for these changes, hospitals will need to substantially reengineer their discharge notification process. For more information, including copies of the slides presented during the May 29 special ODF call and copies of the revised notices (both of which have now been finalized), visit CMS's Hospital Discharge Appeal Notices Web site.

Second, you may be surprised to learn that CMS held its regular hospital ODF on May 24. The reason this may surprise you is that I strongly suspect that, for some unexplained reason, notices for this call were never sent out. I never received one and neither did any of my HCPro colleagues. I found out about the call on the day the encore playback was set to expire and managed to catch the taped version just before it was deleted. The other reason I suspect that the notices never went out was that there was only one question asked during the Q&A portion of the call. In fact, the call only lasted 30 minutes instead of the usual hour. I will follow-up with CMS and see if I can get them to change the way they announce these calls in the future so that everyone can participate. The next hospital ODF call is scheduled for Thursday, July 12.

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