Health Information Management

The week in Medicare updates

APCs Insider, February 7, 2014

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Affordable Care Act bundled payments for care improvement initiative
On January 24, CMS issued a transmittal to update the participating hospital files, episodes, and prospective bundled payment amounts associated with the Bundled Payments for Care Improvement initiative, Model 2 and Model 4. The number for this recurring update is R21462Q.
Effective date: April 1, 2014
Implementation date: April 7, 2014
View Transmittal R94DEMO.
View a related fact sheet.
 
Inter-jurisdictional reassignments
On January 24, CMS issued a transmittal to address situations when a physician or non-physician practitioner reassigns his or her Medicare benefits to an entity located in another contractor jurisdiction.
Effective date: February 25, 2014
Implementation date: February 25, 2014
View Transmittal R503PI
View MLN Matters® MM8545.
 
April 2014 quarterly drug pricing files and revisions to prior quarterly pricing files
On January 24, CMS issues a transmittal stating that payment allowance limits under the OPPS are incorporated into the Outpatient Code Editor through separate instructions. Change Request (CR) 8607, from which this article is taken,  instructs Medicare contractors to implement the April 2014 ASP Medicare Part B drug pricing file for Medicate Part B drugs
Effective date: April 1, 2014
Implementation date: April 7, 2014
View Transmittal R2863CP
View MLN Matters MM8607.
 
Medicare Claims Processing Manual update for ICD-10 and ASC X12
On January 24, CMS issued a transmittal containing language-only changes for updating ICD-10 and ASC X12 language in Pub 100-04, Chapter 4.
Effective date: October 1, 2014
Implementation date: October 1, 2014
View Transmittal R2862CP.
 
Identification of outpatient time associated with an inpatient hospital admission and claim for payment
On January 24, CMS issued a transmittal to notify contractors that the National Uniform Billing Committee redefined occurrence span code 72 for inpatient bills, so that contractors may denote contiguous outpatient hospital services that preceded the inpatient admission. This should permit the contractor to determine the total time in the hospital, as it is voluntarily recorded on an inpatient claim.
Effective date: December 1, 2013
Implementation date: February 25, 2014
View Transmittal R1334OTN
View MLN Matters MM8586.
 
 
Medicare’s delivery system reform initiatives achieve significant savings and quality improvements
On January 30, CMS released findings on a number of its initiatives to reform the healthcare delivery system. These include interim financial results for select Medicare Accountable Care Organization (ACO) initiatives, an in-depth savings analysis for Pioneer ACOs, results from the Physician Group Practice demonstration, and expanded participation in the Bundled Payments for Care Improvement Initiative. Savings from both the Medicare ACOs and Pioneer ACOs exceed $380 million.
View the press release
View a related fact sheet.



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