Corporate Compliance

This week in Medicare updates

Medicare Insider, October 21, 2014

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Electronic Correspondence Referral System (ECRS) notification regarding Defense of Marriage Act and ICD-10 changes
On October 10, CMS released a transmittal changing the definition of spouse under the MSP working aged provisions. Under the revised definition, a spouse may now include an individual of the same sex. Therefore, CMS has modified the ECRS User Guide to reflect this change and modified the ECRS User Guide to reflect the change in implementation date for use of ICD-10 codes.
Effective date: October 1, 2014
Implementation date: January 1, 2015
View Transmittal R105MSP.
View Transmittal R106MSP.
View MLN Matters article MM8875.
Revisions to State Operations Manual (SOM), Appendix W, Interpretive Guidelines for Critical Access Hospitals (CAHs)
On October 10, CMS released a change request providing clarification concerning requirements for equipment maintenance for CAHs, 42 CFR 485.623(b)(1).
Effective date: October 10, 2014
Implementation date: October 10, 2014
View Transmittal R124SOMA.
Information for hospitals and CAHs concerning possible Ebola virus disease
On October 10, CMS posted a document regarding the CDC’s Health Advisory Alert on evaluating patients for possible Ebola virus disease. The CDC has also issued additional guidance, including a checklist and algorithm for patients being evaluated for Ebola virus disease in the United States, as well as a hospital preparedness checklist.
View the survey and certification letter.
Implementing the new moratorium on establishment of new long-term care hospitals (LTCH) or new LTCH satellites, or increases in LTCH beds
On October 10, CMS posted a new statutory moratorium prohibiting, with certain exceptions, the establishment of new LTCHs or new LTCH satellites of existing LTCHs. Additionally, the moratorium prohibits, with no exceptions, an increase in the number of an LTCH’s certified beds. The moratorium is effective April 1, 2014, to September 30, 2017. CMS regional offices will determine whether a hospital seeking to convert to LTCH status, or an LTCH seeking to add a satellite, qualifies for an exception to the moratorium.
View the survey and certification letter.
OIG Advisory Opinion No. 14-09
On October 14, OIG posted a response to a request for an advisory opinion. This opinion was regarding an existing arrangement under which a township uses tax revenues to cover out-of-pocket amounts owed for basic life support emergency ambulance services received by local residents.
View the document.
More updates to Hospital Appeals Settlement offer
On October 14 and 16, CMS updated the information available regarding the Hospital Appeals Settlement offer. CMS noted an error with the electronic mailbox intended to receive requests on this matter has been rectified. They advise anybody who emailed a request between October 11 and October 14, inclusive, and did not receive a confirmation of receipt should resubmit their information. Further, a third National Provider Call on this offer has been scheduled for October 21 at 1 p.m. Eastern time.
View the updated Inpatient Hospital page.
Register for the National Provider Call.
The Advisory Panel on Hospital Outpatient Payment (the Panel) Spring Meeting announced
On October 17, CMS posted a notice on the Federal Register announcing the spring meeting of the Panel for 2015. The purpose of the Panel is to advise the Secretary of the Department of Health and Human Services and the Administrator of CMS on the clinical integrity of the APC groups and their associated weights, and hospital outpatient therapeutic services supervision issues. The first semiannual meeting in 2015 is scheduled for the following dates and time. Consequently, the meetings may be shorter than or last longer than the times listed in this notice, but will not begin before the posted times: Monday, March 9 and Tuesday March 10, 2015, from 9 a.m. to 5 p.m. Eastern.
View the notice on the Federal Register.

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