Revenue Cycle

Important Medicare updates

Medicare Update for CAHs, July 24, 2012

CMS issues three-day payment window FAQs

On June 14, CMS issued 43 new FAQs related to MLN Matters article MM7502, “Bundling of Payments for Services Provided to Outpatients Who Later Are Admitted as Inpatient: 3-Day payment Window and the Impacts on Wholly Owned or Wholly Operated Physician Offices.” The FAQs also address when a CAH that is owned or operated by a PPS hospital and provides outpatient services prior to admission to the PPS hospital.

View the FAQs.

CMS issues 2013 OPPS proposed rule

On July 6, CMS issued a display copy of the 2013 OPPS proposed rule, which among other changes, would implement a 2.1% increase in payment rates. CAHs should also review the proposed rule for changes regarding supervision of hospital outpatient therapeutics services including physical, occupational and speech therapies.  

View a display copy of the rule.

View a related fact sheet.

View a related press release.

CMS issues 2013 physician fee schedule proposed rule

On July 6, CMS issued a display copy of the 2012 physician fee schedule proposed rule that would update payment policies and payment rates for services furnished under the Medicare Physician Fee Schedule (MPFS) on or after Jan. 1, 2013.

View the proposed rule.

View a related fact sheet.

View a related fact sheet on the physician value-based payment modifier and physician feedback program.

View a related fact sheet on physician quality programs.

View a related press release.

Submit a comment.

CMS issues 2013 home health prospective payment system update

On July 6, CMS issued a display copy of the 2013 home health PPS rate update and hospice quality reporting requirements and survey and enforcement requirements for home health agencies.

View a display copy of the rule.

View a related press release.

Submit a comment.

CMS issues 2013 ESRD prospective payment system proposed rule

On July 2, CMS issued a display copy of the 2013 ESRD PPS, quality incentive program, and bad debt reductions for all Medicare providers proposed rule.

View a display copy of the rule.

View a related fact sheet.

View a related fact sheet on the quality incentive program.

View a related press release.

CMS issues transmittal on new interest rate for Medicare overpayments and underpayments

On July 11, CMS issued a transmittal that gives notice of new interest rate for Medicare overpayments and underpayments, which applies to Chapter 3, Section 10.

Effective date: July 18, 2012

Implementation date: July 18, 2012

View transmittal R211FM

CMS issues an NCD for wrong surgical or other invasive procedure performed on a patient (140.6)

On July 10, CMS issued a national coverage determination (NCD) for wrong surgical or other invasive procedure performed on a patient (140.6)

View the NCD.

CMS issues an NCD for tumor antigen by immunoassay – CA 125 (190.28)

On July 9, CMS issued a national coverage determination (NCD) for tumor antigen by immunoassay – CA 125 (190.28)

View the NCD.

Most Popular