Health Information Management

The week in Medicare updates

HIM-HIPAA Insider, February 23, 2015

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Implementation date for laboratory travel allowance fee updated

On February 5, CMS rescinded and replaced a transmittal released in January on the Laboratory Travel Allowance to update the implementation date.
 
Effective date: January 1, 2015
Implementation date: As soon as possible, but no later than April 24, 2015
 
View Transmittal R3189CP.
 
Recovery Auditor-specific “no documentation” medical necessity denial reason code added
On February 6, CMS released a change request to provide a Recovery Auditor-specific "no documentation" reason code for Medicare Administrative Contractors to append to prepayment claim denials.
 
Effective date: July 1, 2015
Implementation date: July 6, 2015 for Define/Analyze and Design Application; October 5, 2015 for hours for code development/test and alpha testing
 
View Transmittal R1462OTN.
 
Fact sheet on Oncology Care Model posted
On February 12, CMS posted a fact sheet regarding its development of new payment and service delivery models that will improve quality and reduce the cost of specialty care. The Oncology Care Model (OCM) is the second specialty care model to be announced. OCM is an innovative multi-payer model in which practices enter into payment arrangements that include financial and performance accountability for episodes of care surrounding chemotherapy administration to cancer patients.  This model aims to provide higher quality, more highly coordinated oncology care at a lower cost. OCM is a five-year model and will begin in spring 2016.
 
View the fact sheet.
View the press release.
 
OIG posts advisory opinion regarding the effect of exclusion from federal healthcare programs
On February 13, OIG posted Advisory Opinion 15-02. This advisory opinion is regarding exclusion from federal healthcare programs.
 
View the report.



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