Case management directors and their staffs are vigilantly watching the nursing homes in their areas to determine which nursing homes have available beds and which may have no beds at all due to a novel coronavirus (COVID-19) outbreak.
Q: In the 2021 OPPS proposed rule, CMS suggested that there is no longer a need for the inpatient-only list. What could this mean for case managers going forward?
Is the inpatient-only list soon to be a thing of the past? It’s possible. In the 2021 OPPS proposed rule, released August 3, CMS suggested that there is no longer a need for the inpatient-only list. Instead, CMS recommended deferring to the physician’s clinical judgment.
Q: While telemedicine is becoming ubiquitous, we must face the reality that not every patient is capable of effectively accessing or utilizing these tools. What are your suggestions for helping these patients?
Last month, Case Management Monthly provided tips to help support patients using technology during the novel coronavirus (COVID-19) pandemic. Since then, the Journal of the American Medical Association (JAMA) published a research letter underscoring the need for this support.
Matty, an expert utilization review (UR) case manager, is shocked when she receives a letter denying payment for the entire hospital stay of Michael, who has recovered after falling severely ill with the novel coronavirus (COVID-19).
