Tag: CMS

Recovery centers extend stays beyond 24 hours

One of the last things ambulatory surgery center (ASC) staff want to do is transfer a patient to a hospital because it increases the risk of infection and patient discomfort, and it’s a Centers for Medicare & Medicaid Services (CMS) quality measure (ASC-4). CMS and most states traditionally have not…

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By: OR Manager
January 20, 2016
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Nearly 209,000 healthcare providers receive 'meaningful use' penalties

Editor's Note Nearly 209,000 physicians and other healthcare providers will receive 2% cuts in their Medicare payments in 2016 for failing to meet meaningful use standards in 2014. The penalties total an estimated $600 million. Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services, said on January…

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By: Judy Mathias
January 19, 2016
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Reliability of cost profiles for surgery based on Medicare data

Editor's Note Medicare data on payments for inpatient surgery are a reliable measure of hospital costs for commonly performed procedures, but are less reliable for lower volume procedures, this study finds. With increased emphasis on shifting risk from payers to providers through bundled payments and accountable care organizations, hospitals are…

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By: Judy Mathias
January 14, 2016
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CMS issues revised guidelines for 'two-midnight' rule

Editor's Note The Centers for Medicare & Medicaid Services (CMS), on January 1, issued revised guidelines on “Reviewing Short Stay Hospital Claims for Patient Status: Admissions On or After January 1, 2016.” Under the revised exceptions policy for admissions not meeting the two-midnight benchmark, Part A payment may be appropriate…

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By: Judy Mathias
January 14, 2016
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Readmissions associated with hospital characteristics

Editor's Note Select hospital characteristics are associated with readmissions after major surgical procedures, this study finds. After adjusting for patient factors, rural location was predictive of readmission after colectomy. Low-volume and minority-serving hospitals were associated with greater odds of readmission after total joint arthroplasties. Because financial penalties may worsen performance…

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By: Judy Mathias
January 14, 2016
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Meaningful Use to end in 2016

Editor's Note The Meaningful Use program will be ending some time in 2016, the Centers for Medicare & Medicaid Services acting administrator, Andy Slavitt, announced January 11. New value-based payment regulations demand a more streamlined regulatory approach, noted Slavitt, speaking at the J P Morgan Healthcare conference in San Francisco.…

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By: Judy Mathias
January 13, 2016
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Bill allowing MU Stage 2 hardship exemptions signed into law

Editor's Note A bill designed to make it easier for healthcare providers to receive hardship exemption from financial penalties for failing to meet Stage 2 meaningful use (MU) electronic health record (EHR) requirements was signed into law on December 28, 2015, the January 4, 2016, iHealthBeat reports. The bill ensures…

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By: Judy Mathias
January 5, 2016
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CMS finalizes rule on prior authorization for durable medical equipment, supplies

Editor's Note The Centers for Medicare & Medicaid Services (CMS), on December 30, 2015, published a final rule that establishes a prior authorization process for certain durable medical equipment, prosthetics, orthotics, and supplies to help reduce unnecessary and fraudulent claims. Under the final rule, the same information necessary to submit…

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By: Judy Mathias
January 4, 2016
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CMS announces ASC quality reporting appeals process

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on December 16 announced that ambulatory surgery centers (ASCs) subject to a reduction in Medicare outpatient payments in CY 2016 because of noncompliance with the ASC quality reporting program may submit a request for reconsideration by March 17, 2016. Eligible…

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By: Judy Mathias
December 17, 2015
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Congress considers MU incentives for ASCs

Editor's Note A Bill in Congress would enable ambulatory surgery center (ASC) physicians to receive the same payment incentives for meaningful use (MU) of electronic health records (EHRs) as physicians in other settings, according to the December 15 Healthcare IT News. Currently, physicians practicing in ASCs are excluded. The Electronic…

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By: Judy Mathias
December 16, 2015
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