Revenue Cycle

First of 2012: CMS announces supervision decisions for select services

Recovery Auditor Report, June 14, 2012

In the 2012 outpatient prospective payment system (OPPS) final rule, CMS established a process to utilize the hospital outpatient payment panel to recommend the appropriate levels of supervision for individual hospital outpatient therapeutic services. Following panel meetings at or around March and August of each year, CMS said it would consider panel recommendations and post decisions regarding individual services on its website. From there, there would be a 30-day waiting period for providers to make comments on the decisions, which would then lead to the finalized decisions going into effect in July or January, depending on the panel meeting.

For the most recent panel meeting, however, the initial determination was not well announced, and the ability to request determinations and make comments may have slipped by unnoticed for many providers, according to Kimberly Anderwood Hoy, JD, CPC, director of Medicare and compliance at HCPro, Inc.

“I knew that determinations were supposed to be released for comment, yet I didn’t see anything on the website or hear anything on the open door forums, so I thought that perhaps the first panel meeting would be held in August due to the short time between the final rule and the first proposed meeting,” she says. “But CMS did display the recommendations for comment and finalize them, although it was not well publicized.”

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