Health Information Management

The week in Medicare updates

HIM-HIPAA Insider, November 10, 2014

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Part 2, Provider Cost Reporting Forms and Instructions, Chapter 11, Provider Reimbursement Manual, Form CMS-339
On October 24, CMS rescinded and replaced Transmittal 7, dated October 2014, with Transmittal 8. This issuance was to change the effective date from cost reporting periods ending on or after June 30, 2014, to cost reporting periods ending on or after September 30, 2014, and to add a portion of sentence to the note under Step B.1 on Page 11-11 which was inadvertently omitted. All other information remains the same.
 
Effective date: Cost reporting periods ending on or after September 30, 2014
 
View Transmittal R8P211.
 
Tests subject to CLIA Edits downloadable file
On October 24, the Tests Subject to CLIA Edits downloadable file, which is updated on a yearly basis, was posted. Information in the column labeled LABORATORY CERTIFICATION (LC) CODE is for informational purposes only.
 
View the survey and certification letter.
 
Update regarding Hospital Appeals Settlement offer 
On October 27, CMS posted updated Frequently Asked Questions regarding the Hospital Appeals Settlement offer.
 
View the Frequently Asked Questions.
 
CMS announces payment changes for Medicare home health agencies for 2015 
On October 30, CMS announced changes to the Medicare home health prospective payment system (HH PPS) for CY 2015 in order to foster greater efficiency, flexibility, and payment accuracy, and improve quality. Approximately 3.5 million beneficiaries received home health services from nearly 12,000 home health agencies, costing Medicare approximately $18 billion in 2013.
 
View the fact sheet.
 
Drug compendia publishers maintain transparent processes for evaluating anticancer drug therapies and identifying potential conflicts
On October 31, OIG released a report detailing a study on drug compendia publishers’ policies and procedures as they relate to processes for evaluating anticancer drug therapies and identifying potential conflicts of interest on the part of their staff. OIG found each of the publishers of the four authorized compendia complied with federal laws for maintaining a transparent process for evaluating anticancer drug therapies and identifying potential conflicts of interest, and the number and nature of disclosures related to potential conflicts of interest varied across publishers.
 
View the report.
 
Medicare paid for HIV drugs for deceased beneficiaries 
On October 31, OIG released a report regarding payments for HIV drugs made to deceased beneficiaries. OIG found CMS’ current practices allowed many of these payments to occur.
 
View the report.



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