Revenue Cycle

Important Medicare updates

Medicare Update for CAHs, March 21, 2012

OIG posts review of Medicare outpatient billing for selected drugs at NorthBay Medical Center (CA)

On March 5, CMS posted an audit report for NorthBay Medical Center, located in Fairfield, CA. For 99 of the 121 line items reviewed, NorthBay Medical Center did not bill Medicare for injections of selected drugs in accordance with federal requirements, resulting in overpayments totaling $70,000. 

View the complete report

CMS makes quarterly OPPS update

On March 2, CMS issued a transmittal to make quarterly updates to the OPPS for April. The transmittal includes guidance on device edits as well as billing for drugs, biologicals, and radiopharmaceuticals.
 
Effective Date: April 1, 2012

Implementation Date: April 2, 2012

View the transmittal

CMS makes minor clarifying and technical edits to Hospital/CAH Worksheet transmittal

On March 1, CMS rescinded Transmittal 79, which revised the Hospital/CAH [critical access hospital] Database worksheet. It was replaced with Transmittal 80 to make some minor clarifying and technical edits in the manual instruction. 

Effective Date: March 1, 2012
Implementation Date: March 1, 2012
 
View the transmittal
 

CMS publishes patient privacy guidance

On March 2, CMS published a certification letter that contains guidance concerning HIPAA standards. The letter specifically addresses permitted incidental uses and disclosures and includes reasonable safeguards that must be in place to ensure patient privacy. 

View the certification letter

CMS publishes EHR Incentive Program—Stage 2 proposed rule

On March 7, CMS published the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs Stage 2 requirements proposed rule in the Federal Register. The Medicare and Medicaid EHR Incentive Programs will consist of three different stages of meaningful use requirements, with each stage requiring increasing use of EHRs and electronic information exchange. 

View the proposed rule 
Submit a comment 

 HHS publishes health information technology standards

On March 7, the U.S. Department of Health and Human Services (HHS) proposed new and revised certification criteria that would establish the technical capabilities and specify the related standards and implementation specifications that Certified Electronic Health Record (EHR) Technology would need to include to, at a minimum, support the achievement of meaningful use by eligible professionals, eligible hospitals, and CAHs under the Medicare and Medicaid EHR Incentive Programs.

View the proposed rule
Submit a comment
 

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