- 2016 OPPS final rule establishes negative payment update, moves 2-midnight rule review to QIOs
The policies in the 2016 OPPS final rule, released Friday, October 30, present a give and take for providers, as CMS finalized a negative payment update for the first time ever, but also listened to commenters on some potentially burdensome proposals.
- Ask the expert: Is the three-day qualifying stay going away?
Under current Medicare rules, patients can only get coverage for a stay in a skilled nursing facility if they’ve spent three consecutive inpatient days in a hospital. If they are receiving observation services, the stay does not quality for coverage.
- Q&A: Requirements for reporting value code FD
Q: Are we still required to report value code FD (credit received from the manufacturer for a replaced medical device) in 2016? We are having an incredibly difficult time getting the information flow to work correctly all the time.
- Add this best practice to improve your results with patients
If you spend more time looking at charts than patients, you might be missing important opportunities to improve care and prevent readmissions.
- Q&A: CMS makes annual updates for items with pass-through status
Q: Is CMS adding any items with pass-through status for 2016? We are starting to look at reimbursement under ICD-10 and wanted to be sure we included these items.
- What is best practice for reviewing reasonable and necessary under the 2-midnight rule?
Compliance with the 2-midnight rule can be tricky for many organizations, which has left many case managers with nagging questions about how to get it right.