Health Information Management

The week in Medicare updates

APCs Insider, July 10, 2015

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CMS released 2016 OPPS proposed rule
On July 1, CMS released CMS-1633-P, the CY 2016 hospital OPPS and ASC payment system policy changes, quality provisions, and payment rates proposed rule. CMS proposes updates to Medicare payment policies and rates for hospital outpatient departments, ASCs, and partial hospitalization services provided by community mental health centers, and changes that encourage high-quality care in these outpatient settings. This proposed rule also includes important proposed changes to the 2-midnight rule for CY 2016. Comments are due August 31.
View CMS-1633-P.
View the fact sheet.
View the fact sheet on the 2-midnight rule.
Leave a comment.
 
CMS posts letter on use of portable reverse osmosis units and block carbon
On June 26, CMS posted a survey and certification letter regarding portable reverse osmosis (RO) units that meet Association for the Advancement of Medical Instrumentation water quality standards, as incorporated by reference in the end-stage renal disease (ESRD) condition for coverage at 42 CFR Section 494.40, may be used in outpatient dialysis facilities. ESRD surveyors should follow the ESRD Core Survey process in conjunction with this guidance for use of portable RO units and block carbon in outpatient dialysis facilities.
View the survey and certification letter.
 
CMS revises Medicare Claims Processing Manual for foreign, emergency, and shipboard claims
On June 30, CMS rescinded Transmittal 3199 and replaced it with Transmittal 3287 to re-designate sections 340 and 350 to sections 350 and 360, respectively. All other information remains the same. This change request revises the instruction found in the Medicare Claims Processing Manual for processing foreign, emergency, and shipboard claims.
Effective date: April 21, 2015
Implementation date: April 21, 2015
View Transmittal R3287CP.
 
OIG posts compliance review of the University of Kentucky HealthCare
On June 30, the Office of Inspector General posted a report detailing a Medicare Compliance Review of the University of Kentucky HealthCare that found the hospital complied with Medicare billing requirements for 154 of the 232 inpatient and outpatient claims that it reviewed. However, the hospital did not fully comply with Medicare billing requirements for the remaining 78 claims, resulting in overpayments of $209,000.
View the complete report.



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