The week in Medicare updates
APCs Insider, April 25, 2014
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CMS extends coverage of aprepitant for chemotherapy-induced emesis
On April 15, CMS issued a change request to extend coverage of the oral antiemetic three-drug regimen of oral aprepitant, an oral 5HT3 antagonist, and oral dexamethasone to beneficiaries who are receiving certain anti-cancer chemotherapeutic agents.
Effective date: May 29, 2013
Implementation date: July 7, 2014
Medicare Contractor for Jurisdiction 10 overpaid providers for selected outpatient drugs
Payments that the Medicare Contractor for Jurisdiction 10 made to providers for 492 of the 998 line items for outpatient drugs reviewed were not correct, according to the OIG. These incorrect payments resulted in overpayments of $1.2 million and underpayments of $20,000. Providers had not identified and refunded any overpayments for these line items before OIG fieldwork. The remaining 506 line items were correct.
Hospital outpatient advisory panel issues final recommendations and agenda
The Advisory Panel on Hospital Outpatient Payment (HOP) released a list of its final hospital outpatient payment recommendations based on its March 10 meeting. CMS is proposing changes to certain outpatient supervision level requirements described in the CY 2012 OPPS/ASC Final Rule. The requirements open to public comment are outlined in CMS’ preliminary decisions on the recommendations of the HOP Panel on supervision levels for select services. Comments may be submitted via email to HOPSupervisionComments@cms.hhs.gov through 5 p.m. (Eastern) April 30. As indicated in the final rule, CMS will consider any comments and post final decisions that will be effective July 1.
Medicare and Medicaid programs: Fire safety requirements for certain healthcare facilities
On April 16, CMS opened a proposed rule for public comment. The rule would amend the fire safety standards for certain Medicare and Medicaid participating hospitals and facilities. Further, this proposed rule would adopt the 2012 edition of the Life Safety Code (LSC) and eliminate references in CMS regulations to all earlier editions. It would also adopt the 2012 edition of the Health Care Facilities Code with some exceptions. CMS is providing the LSC citation, a description of the 2012 requirement, and an explanation of its benefits for health care facilities, patients, staff, and visitors over the 2000 version in each occupancy section. Comments must be received by June 16.
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