Medicare

Latest Issue of OR Manager
April 2021

Hospitals ramp up outpatient TJA in the COVID-19 era

Fueled by a pandemic, patient demand, and competition with ambulatory surgery centers (ASCs), hospital outpatient department (HOPD) leaders are feeling the push to offer same-day discharge for total joint arthroplasty (TJA). Outpatient TJA is nothing new, but it’s certainly growing in popularity, says John W. Stirton, MD, MBA, medical director…

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By: Jennifer Lubell
March 19, 2021
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Hospital groups ask US Senate for $35B in COVID-19 relief funds

Editor's Note Nine hospital groups have asked the US Senate to add $35 billion to COVID-19 relief legislation to help them deal with financial effects of the COVID-19 pandemic, the February 25 Fierce Healthcare reports. The $1.9 trillion COVID-19 relief bill passed by the House does not include a provider…

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By: Judy Mathias
March 2, 2021
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More states report telehealth reimbursement laws

Editor's Note A Foley & Lardner survey finds that state telehealth reimbursement laws have significantly increased during the COVID-10 pandemic, but more can be done to address telehealth adoption barriers, the February 15 Revcycle Intelligence reports. More than 43 states and Washington, DC, have some telehealth statute for commercial payers,…

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By: Judy Mathias
February 18, 2021
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Joint Commission conducting both virtual and onsite surveys in 2021

The Joint Commission stopped doing most onsite surveys and reviews from March 16 to May 31, 2020, in response to the COVID-19 pandemic. During that time, they developed processes for conducting offsite or virtual events, and as of mid-December, more than 1,200 offsite surveys and reviews had been conducted across…

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By: Judith M. Mathias, MA, RN
February 17, 2021
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New year brings some changes to quality reporting criteria

The 2021 Medicare Hospital Outpatient Prospective Payment System (OPPS)/ASC Final Payment Rule was released on December 1, 2020, and became effective as of January 1, 2021. Gina Throneberry, MBA, RN, CASC, CNOR, director of education and clinical affairs, Ambulatory Surgery Center Association (ASCA), summarized the status of Medicare regulations and…

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By: Elizabeth Wood
January 19, 2021
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COVID-19 has hastened outpatient surgery migration

The latest surge of COVID-19 cases has put many hospitals in a precarious position, with shortages of staff, space, and supplies. Lessons learned earlier in the pandemic cannot necessarily shore up systems that have been overwhelmed with patients. Throughout most of 2020, some patients postponed medical or surgical care. When…

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By: Elizabeth Wood
December 15, 2020
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CMS releases final 2021 Medicare payment rule for ASCs, HOPDs

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on December 2 released its 2021 final payment rule for ASCs and hospital outpatient departments (HOPDs). CMS has finalized the addition of 11 procedures to the ASC covered procedures list, including total hip arthroplasty, autochondrocyte knee implant, and open complex…

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By: Judy Mathias
December 3, 2020
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CMS releases final PFS for 2021, surgeons say rule jeopardizes care

Editor's Note The Centers for Medicare and Medicaid Services (CMS) on December 1 released its 2021 final rule for the Medicare physician fee schedule (PFS), which expands telehealth services and increases payments for primary care and chronic disease management. The rule also reduces payments for surgeons, emergency physicians, and other…

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By: Judy Mathias
December 2, 2020
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Access OR Manager Conference sessions by December 31

For the first time in its history, the annual OR Manager Conference was held virtually September 30 to October 2. Many things were different this year, but the robust educational content and advanced technology were the same as in previous years. In a post-conference survey, more than 60% of respondents…

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By: Elizabeth Wood
November 17, 2020
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Shifts in case mix bode well for future of outpatient surgery

Before COVID-19 emerged as the biggest disruptor of 2020, many ambulatory surgery centers (ASCs) had been growing volume and receiving Medicare reimbursements for an increasing number of procedures. Stopping elective procedures in the spring was a significant setback, especially for smaller, independent facilities, notes a Global Healthcare Advisors (GHA) brief,…

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By: Elizabeth Wood
November 17, 2020
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