Health Information Management

The week in Medicare updates

HIM-HIPAA Insider, October 28, 2013

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VMS prepayment review report

On September 27, CMS issued a rescind and replace transmittal to include the correct file layout for all claims chosen for prepayment review by system edits implemented by the contractors and/or CMS.

Effective date: October 1, 2013

Implementation date: October 7, 2013

View Transmittal R1297OTN.
 

Medicare Financial Management Manual, Chapter 7, Internal Controls

On September 27, CMS issued a transmittal to update and provide clarification for Office of Management and Budget (OMB) A-123 and Internal Control over Financial Reporting.

Effective date: October 1, 2013

Implementation date: October 28, 2013

View Transmittal R228FM.
 

State Operations Manual (SOM) Chapter 2 Policy and Nomenclature Revisions for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)

CMS revised Chapter 2, Sections 2130–2143, “Intermediate Care Facilities” to reflect current Survey and Certification policy memos regarding ICF/IID.

View Transmittal R91SOMA.
 

Prevent Electronic Correspondence Referral System (ECRS) inquiries from being submitted with Insurance types A, K, J, R, S, or blank spaces

On September 27, CMS issued a transmittal stating that currently contractors can create ECRS Inquiries using Insurance types other than A, J, K, R, S, or blanks (blanks/spaces are defaulted to "A"). When this occurs, the system creates the MSP record and rejects it with an SP 24 error. Since the insurance type field is not updatable, the record has to be manually rejected and added with insurance type "A".

Effective date: October 1, 2013

Implementation date: October 1, 2013

View Transmittal R97MSP.
 

Medicare Remit Easy Print (MREP) Annual Enhancement

On September 27, CMS issues a transmittal to instruct the developer of the Medicare Remit Easy Print (MREP) software to update based on enhancement requests received through the Medicare Administrative Contractors (MAC) and/or the CMS website.

Effective date: January 1, 2014

Implementation date: January 6, 2014

View Transmittal R2795CP.
View MLN Matters article M8467.
 

MSC prepayment review report

On September 27, CMS issued a rescind and replace transmittal to include the correct file layout for all claims chosen for prepayment review by system edits implemented by the contractors and/or CMS.

Effective date: October 1, 2013

Implementation date: October 7, 2013

View Transmittal R1299OTN
 

CWF Editing for Vaccines Furnished at Hospice

On September 30, CMS issued a transmittal to replace CARC 171 with CARC 170 in business requirements 8098.2 and 8098.4. All other information remains the same.

Effective date: October 1, 2013

Implementation date: October 7, 2013

View Transmittal R1298OTN.
 

Home Health - Clarification to Benefit Policy Manual language on Confined to the Home definition

On October 18, CMS issued a transmittal giving instruction to clarify the definition of the patient as being "confined to the home" to more accurately reflect the definition as articulated at Section 1835(a) of the Social Security Act. In addition, vague terms, such as "generally speaking," have been removed to ensure clear and specific requirements of the definition.

Effective date: November 19, 2013

Implementation date: November 19, 2013

View Transmittal R172BP.
View MLN Matters article MM8444.



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