This week’s Medicare updates include additional information on denial of home health payments when required patient assessment is not received; Advanced Provider Screening phase 1 go-live; an MLN Matters article on billing for Advance Care Planning claims; and more!
This week’s Medicare updates include an OIG report regarding hospital noncompliance with Medicare Requirements for billing outpatient right heart catheterizations with heart biopsies; a new educational initiative to raise awareness of chronic care management; quarterly updates to the ESRD PRICER; and more!
This week’s Medicare updates include an OIG Advisory Opinion; new MOON FAQs; a CMS transmittal clarifying admission order and medical review requirements; and more!
Where can we find the new Medicare Physician Fee Schedule (MPFS) rate for outpatient prospective payment system (OPPS), non-excepted departments? It didn’t seem to be clearly located on the MPFS final rule relative value units (RVU) file. Are we supposed to assume an exact 50% reduction of the OPPS rate?
In several recent reports, the Office of Inspector General (OIG) determined that providers are, on average, variant from expected volumes on both short stay inpatient and long stay observation cases. What was not made clear in the OIG report is the reason why it believes such variances exist. The answer to this question likely rests within the details of how hospitals have adjusted (or not adjusted) to the use and application of “new criteria” in their daily and ongoing Medicare billing compliance processes.
