Health Information Management

The week in Medicare updates

APCs Insider, April 24, 2015

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CMS posts final decision on HIV screening  
On April 13, CMS posted a final decision memorandum expanding coverage in section 210.7 of the Medicare National Coverage Determinations Manual. CMS has determined evidence is adequate to conclude that screening for HIV infection for all individuals between the ages of 15 and 65 years, as is recommended with a grade of A by the U.S. Preventive Services Task Force, is reasonable and necessary for the early detection of HIV and is appropriate for individuals entitled to benefits under Part A or enrolled under Part B. CMS will cover screening for HIV with the appropriate FDA-approved laboratory tests and point-of-care tests for beneficiaries who meet certain conditions. 
View the final decision memorandum.
CMS replaces April 2015 update of the hospital OPPS 
On April 14, CMS rescinded and replaced the April quarterly OPPS update transmittal to correct the payment rate for HCPCS code C9447 (injection, phenylephrine and ketorolac, 4 ml vial) found in table 11, attachment A. CMS also made a correction to business requirement 9097.3. CMS removed references to HCPCS codes J0365 and J7180 from section 4 of the business requirements document and deleted a table from attachment A. All other information remains the same. 
Effective date: April 1, 2015
Implementation date: April 6, 2015 
View Transmittal R3235CP.
CMS proposes electronic health record incentive program modifications  
On April 15, CMS posted a proposed rule in the Federal Register that would change the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program reporting period in 2015 to a 90-day period aligned with the calendar year. CMS also proposed aligning the EHR reporting period in 2016 with the calendar year. In addition, this proposed rule would modify the patient action measures in the Stage 2 objectives related to patient engagement. It would also streamline the program by removing reporting requirements on measures that have become redundant, duplicative, or topped out through advancements in EHR function and provider performance for Stage 1 and Stage 2 of the Medicare and Medicaid EHR Incentive Programs. Comments are due June 15. 
View the notice in the Federal Register
View the fact sheet
Leave a comment.
CMS posts fact sheet on Hospital Compare star ratings 
On April 15, CMS posted a fact sheet regarding the Hospital Compare website. Hospital Compare is a consumer-oriented website that provides information on how well hospitals provide care to their patients. This information can help consumers make informed decisions about healthcare. Hospital Compare allows consumers to select multiple hospitals and directly compare performance measure information related to heart attack, heart failure, pneumonia, surgery, and other conditions. 
View the fact sheet
View the press release.
CMS issues proposed decision memorandum for screening for cervical cancer with HPV testing 
On April 16, CMS posted a proposed decision memorandum stating evidence is sufficient to add human papillomavirus (HPV) testing once every five years as an additional preventive service benefit under the Medicare program for asymptomatic beneficiaries aged 30 to 65 years in conjunction with the pap smear test. CMS will cover screening for cervical cancer with the appropriate FDA-approved/cleared laboratory tests.
View the proposed decision memorandum.

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