The week in Medicare updates
APCs Insider, June 13, 2014
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CMS rescinds and replaces Transmittal 166 for technical correction
On May 28, CMS released a change request to rescind and replace Transmittal 166, dated April 18, with Transmittal 168. This change request was to make a technical correction to delete information in the National Coverage Determinations Manual that should not have been included. All other information remains the same.
View Transmittal R168NCD.
Revision to the Program Integrity Manual, Chapter 15
On May 30, CMS released a change request to revise various sections of the Program Integrity Manual, Chapter 15. These revisions do not establish any new CMS policies; they merely recite various regulatory provisions (as well as material from the Medicare Benefit Policy Manual, Chapter 15).
Effective date: July 31, 2014
Implementation date: July 21, 2014
View Transmittal R519PI.
CMS releases annual update to data on hospital charge variation
On June 2, CMS released its first annual update to data on hospital charges. The data includes inpatient and outpatient hospital charge data for 2011 and 2012, and shows what different hospitals in all 50 states and Washington, D.C., charge for similar services. The data show significant variation in average charges from hospital to hospital—including those within the same community—for inpatient services that may be provided in connection with a given inpatient stay.
View the fact sheet.
CMS to cover screening for hepatitis C in adults with approved tests
In a decision posted June 2, CMS stated it will cover screening for hepatitis C with the appropriate FDA approved/cleared laboratory tests. It must be consistent with FDA-approved labeling and in compliance with CLIA regulations, and must be ordered by the beneficiary's primary care physician or practitioner within the context of a primary care setting. It can be performed by an eligible Medicare provider for beneficiaries who meet one of certain conditions.
View the decision.
Identify infection control breaches which warrant referral to public health authorities
If State Survey Agencies (SA) or Accrediting Organizations identify any of breaches of generally accepted infection control standards, they should refer them to appropriate state authorities for public health assessment and management. SAs should consult with their state’s Healthcare Associated Infections Prevention coordinator or state epidemiologist on the preferred referral process.
View the survey and certification letter.
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