Health Information Management

This week's Medicare updates

APCs Insider, September 20, 2013

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Home Health Change of Care Notice (HHCCN), Form CMS-10280, Manual Instructions

On September 6, CMS issued a transmittal to introduce and implement the Home Health Change of Care Notice (HHCCN) and instructions. The previously used Home Health Advance Beneficiary Notice (HHABN), Form CMS-R-296 (CR 7323), will be discontinued.

Effective date: December 9, 2013
Implementation date: December 9, 2013

View Transmittal R2781CP.

View MLN Matters article MM8403

Corrections to the Medicare Claims Processing Manual

On September 10, CMS issued a rescind and replace transmittal to restore erroneously deleted section 60.1.1 to the chapter and to correctly delete section from the chapter. Also, the effective and implementation dates are being revised to September 30, 2013. All other information remains the same.

Effective date: September 30, 2013
Implementation date: September 30, 2013

View Transmittal R2783CP.

Corrections to tracking Medicare contractor postpayment reviews

On September 13, CMS issued a rescind and replace transmittal to clarify that the Medicare Administrative Contractors (MACs) shall upload claims to the Recovery Audit Data Warehouse by the 20th day of every month for the previous month. In addition, the contact information is being corrected and the phrase “file layout for claims uploaded to the Recovery Audit Data Warehouse” is being added to the manual instructions. All other information remains the same.

Effective date: October 3, 2013
Implementation date: October 3, 2013

View Transmittal R487PI.


Influenza vaccine payment allowances annual update for 2013-14 season

On September 13, CMS issued a transmittal to notify providers of the payment allowances for seasonal influenza virus vaccines as updated on an annual basis, effective August 1 of each year.

Effective date: August 1, 2013
Implementation date: No later than October 25, 2013

View Transmittal R2786CP.

View MLN Matters article MM8433


Additional reporting requirements concerning physician ownership and investment in hospitals

On September 13, CMS issued a special edition article to address the additional reporting requirements imposed by Section 6001 of the Affordable Care Act on physician-owned hospitals seeking to avail themselves of the whole hospital or rural provider exception to the physician self-referral law.

View Special Edition article SE1332.

OIG report: Medicare Recovery Audit Contractors and CMS' actions to address improper payments, referrals of potential fraud, and performance

On September 3, the Office of Inspector General (OIG) issued a report regarding vulnerabilities in CMS’ oversight of its contractors resulting in improper payments totaling $1.3 billion.

View the OIG report

OIG report: Medicare could collect billions if pharmaceutical manufacturers were required to pay rebates for Part B drugs

On September 9, the OIG issued a report stating Medicare could have collected $3.1 billion if pharmaceutical manufacturers had been required in 2011 to pay average manufacturer’s price-based rebates for 60 high-expenditure Part B drugs, representing 22% of spending for those drugs.

View the OIG report.  

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