Health Information Management

The week in Medicare updates

HIM-HIPAA Insider, April 7, 2014

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Health Professional Shortage Area (HPSA) Post-payment Review Process

On March 25, CMS issued a rescind and replace transmittal to remove language in Transmittal 2890 that references the HPSA quarterly report. All other information remains the same.
View Transmittal R2914CP.
Effective date: March 31, 2014
Implementation date: March 31, 2014
Medicare National Coverage Determination (NCD) for Beta Amyloid Positron Emission Tomography (PET) in Dementia and Neurodegenerative Disease
On March 27, CMS issued a rescind and replace transmittal to update the NCD for PET in dementia and neurodegenerative disease.  
View Transmittal R2915CP.
View Transmittal R164NCD.
Effective date: September 27, 2013
Implementation date: July 7, 2014
Medicare Contractors for Jurisdiction 8 Overpaid Providers for Selected Outpatient Drugs
Medicare contractors for Jurisdiction 8 made incorrect payments to providers for 692 of the 1,177 line items for outpatient drugs, according to a March 18 OIG report. . These incorrect payments resulted in overpayments of $2.9 million and underpayments of $28,000 that the providers had not identified, refunded, or adjusted by the beginning of OIG's audit.
View the report.
CMS did not always correctly make clinic visit payments to hospitals
On March 12, the OIG issued a report stating that CMS made incorrect outpatient payments to hospitals for established patients' clinic visits.
View the report.

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