Medicare

CMS releases OPPS rule for 2016, finalizes two-midnight changes: 10 things to know

Written by Ayla Ellison for Becker’s Hospital CFO CMS released its final 2016 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System rule on Friday, which finalizes CMS’ proposal to alter its controversial two-midnight rule and implements previously announced modifications to CMS’ medical review strategy. Here are 10 things to know about the…

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Medicare tweaks quality and safety programs in hospital payment rule

By Sabriya Rice for Modern Healthcare The CMS floated a slate of tweaks to Medicare’s quality- and safety-reporting requirements in its sweeping proposed rule for 2016 inpatient hospital rates issued last week. Within the 1,500-page draft rule for the Hospital Inpatient Prospective Payment Systems, the CMS outlines changes coming down the pike for the hospital…

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WEDI: ICD-10 Delay Hurt Health Care Industry’s Preparedness

By iHealthBeat The ICD-10 implementation delay has negatively affected stakeholders’ progress preparing for the new code sets, according to a survey by the Workgroup for Electronic Data Interchange, Healthcare IT News reports (McCann, Healthcare IT News, 4/6). Background U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets by Oct. 1…

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HIPAA Audits Are Still on Hold

By Marianne Kolbasuk McGee for Govinfo Security OCR Director Reveals Enforcement Plans for 2015 The unit of the Department of Health and Human Services that enforces HIPAA still has plenty of work to do before it can launch its long-promised next round of HIPAA compliance audits, as planned for this year. The HHS Office for…

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Medicare Fines 2,610 Hospitals In Third Round Of Readmission Penalties

By Jordan Rau for Kaiser Health News Medicare is fining a record number of hospitals – 2,610 – for having too many patients return within a month for additional treatments, federal records released Wednesday show. Even though the nation’s readmission rate is dropping, Medicare’s average fines will be higher, with 39 hospitals receiving the largest…

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Rural Hospitals Excluded from Quality Push

By Jordan Rau for Kaiser Health News Many small, rural hospitals are having a hard time fitting into new accountability standards of the Affordable Care Act. Critical-access hospitals aren’t yet part of Medicare’s pay-for-performance plan, and Congress never provided money for testing how to tie bonuses and penalties to hospital performance. Crawford Memorial Hospital, in…

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Hospitals could face penalties for missing electronic health record deadline

From the University of Michigan on ScienceDaily Many of the nation’s hospitals struggled to meet a federally mandated electronic health records deadline, and as a result could collectively face millions of dollars in reduced Medicare payments this year, a University of Michigan study shows. More than half of U.S. hospitals were on the hook to…

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Small hospitals may lose billions by missing EHR deadline

By Dan Cook for benefitspro A large-scale review of data related to hospital compliance with federal electronic health records mandates reveals that most U.S. hospitals have made substantial progress toward EHR adoption. Nonetheless, because considerable federal dollars are tied to complete adoption, many hospitals — especially small rural ones — could forfeit millions as key…

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Little-known Medicare lawsuit can help clear path to recovery

Medicare patients can’t lose treatment even if they ‘show no improvement,’ says oft-ignored Jimmo v. Sebelius By Gabe Quintanilla for the Houston Chronicle Several days after Christmas last year, my 91-year-old mother suffered a stroke. Up until that time, I had paid very little attention to the topic of Medicare. But in the days that…

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