CMS releases CY 2016 proposed physician payment rule
Editor's Note The Centers for Medicare & Medicaid Services on July 8 released its proposed rule for the physician fee schedule for CY 2016. Physicians will have a 0.5% overall increase in Medicare reimbursement under the rule, which will be finalized this fall. The rule also calls for reimbursement for…
Industry payments to nurses not reported in federal database
Editor's Note Though a nurse practitioner in Connecticut pleaded guilty recently to taking $83,000 in kickbacks from a drug company, the payments were not listed in the Centers for Medicare & Medicaid Services Open Payments Database. That’s because companies are not required under the Physician Payment Sunshine Act to publicly…
CMS, AMA announce efforts to help with transition to ICD-10
Editor's Note In less than 3 months, healthcare providers will switch from ICD-9 to ICD-10 coding for medical diagnoses and inpatient hospital procedures. To help providers get ready for the October 1 deadline, the Centers for Medicare & Medicaid Services is releasing additional guidance that will allow for flexibility in…
New ACS Interactive Web Tool Helps Surgeons Avoid Medicare Penalties
Editor's Note The American College of Surgeons has launched a new web tool to help surgeons navigate and succeed in Medicare’s mandatory quality programs: Physician Quality Reporting System, Electronic Health Record-Meaningful Use, and Value-Based Modifier. Surgeons who do not successfully participate in these programs in 2015 could face up to…
CMS Issues Proposed Rule for Hospital Outpatient and ASC Payments
Editor's Note The Centers for Medicare & Medicaid Services on July 1 issued a proposed rule for CY 2016 for the hospital outpatient prospective payment (OPPS) and ambulatory surgical center (ASC) payment systems. CMS proposes an OPPS decrease of .01%. The change is based on a projected hospital market basket increase…
CMS Proposes Changes to the 'Two-Midnight' Rule
Editor's Note On July 1, the Centers for Medicare & Medicaid Services released proposed updates to the “Two-Midnight” rule regarding when inpatient admissions are appropriate for payment under Medicare Part A. The proposed update allows physicians to use their judgment to admit patients for short hospital stays on a case-by-case…
Editorial
Reports that emerged in late 2014 reflect both progress and problems in healthcare delivery. And while regulatory and financial hurdles continue to loom large in 2015, some of these obstacles are being cleared. The Agency for Healthcare Research and Quality cited an impressive 1.3 million decline in the number of…
CMS replaces flash sterilization with IUSS
The Centers for Medicare & Medicaid Services (CMS) has replaced the term “flash sterilization” with “immediate use steam sterilization” (IUSS) in surgical settings. The change in terminology, which applies to Medicare-participating hospitals, critical access hospitals, and ambulatory surgical centers that are subject to Conditions of Participation or Conditions of Coverage,…
Sharpen coding skills and reimbursement strategies during ICD-10 delay
The Centers for Medicare & Medicaid Services (CMS) once again has extended the deadline to begin using International Classification of Diseases-10 (ICD-10) billing codes. Implementation has been set for October 1, 2015, and a growing number of billing, technology, and clinical specialists agree it is time to move ahead with…
Medicare reimbursement, allowable procedures at forefront of ASC challenges
Leaders of ambulatory surgery centers (ASCs) can expect to continue facing challenges related to reimbursement even as they try to increase the kinds of procedures that can be performed in their facilities, say experts with the Ambulatory Surgery Center Association (ASCA). Other key factors that will determine their future success…
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- Medical error initiative from Joint Commission affiliate NQF targets preventable harm, “never events”
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