Health Information Management

This week?s Medicare updates

APCs Insider, May 24, 2013

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Resigned and replaced CR 6452: Termination of Frontier Extended Stay Clinic demonstration

On May 17, CMS issued a change request to resign and replace CR 6452, which states the claims processing rules for the Frontier Extended Stay Clinic demonstration. The demonstration will terminate effective April 16, 2013, after completing the 3-year period of performance mandated by section 434 of the Medicare Modernization Act. The MAC and FI are no longer to process claims for extended stay services for the participating clinics.
Effective date: April 16, 2013
Implementation date: June 18, 2013
View transmittal R88DEMO
 
Requirement for sending immediate advisements to the OIG/OI
On May 17, CMS issued a change request to clarify the procedures by which the PSCs and ZPICs shall send immediate advisements to the OIG/OI.
Effective date: February 1, 2013
Implementation date: June 18, 2013
View transmittal R466PI
 
Reopening claims with additional information or denied due to late or no submission of requested information
On May 17, CMS issued a change request to clarify the fourth bullet in the Program Integrity Manual (PIM) chapter 3, section 3.2.3.9 to ensure that the contractor who initiated the prepayment edit is responsible for conducting the reopening.
Effective date: June 18, 2013
Implementation date: June 18, 2013
View transmittal R464PI
 
Use of a rubber stamp for signature
On May 17, CMS issued a change request to clarify the use of a rubber stamp for signature on the Program Integrity Manual (PIM).
Effective date: June 18, 2013
Implementation date: June 18, 2013
View transmittal R465PI
 
CMS announces $1 billion initiative to launch healthcare innovation awards
On May 14, CMS released a funding opportunity announcement for round two of the Health Care Innovation Awards. CMS will launch a $1 billion initiative to fund the awards and evaluation to build on the Obama administration’s work to transform the health care system by delivering better care and lowering costs. This second round of Health Care Innovation Awards will fund applicants that have a high likelihood of driving health care system transformation and delivering better outcomes.
View the press release
View the Health Care Innovation Awards website
View a related fact sheet
 
OIG updates LEIE database
On May 14th, the OIG updated its List of Excluded Individuals/Entities and it is currently available for download.
View the updated LEIE list
 
OIG issues report on timely surveys and corrected deficiencies for home health agencies (HHAs)
On May 15th, the OIG released a report using CMS data for Federal fiscal years 2010 and 2011 to identify the extent to which state agencies and accreditation organizations conducted timely recertification surveys of HHAs, to ensure they comply with Federal requirements.
View the report
 
Medicare program: Bundled Payments for Care Improvement Model 1 open period
On May 17, CMS posted a notice to the Federal Register announcing an open period for additional organizations to be considered for participation in Model 1 of the Bundled Payments for Care Improvement initiative. Interested organizations must submit a Model 1 Open Period Information Intake form by July 31, 2013.
View the notice.



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