What is the consequence if we miss giving a patient who meets the Medicare Outpatient Observation Notice criteria the notice? Has there been an update if the observation hours will need a modifier or the claim a value or condition code to show that the notice was given?
Hospitals got a last-minute reprieve from the Medicare Outpatient Observation Notice (MOON) notification requirement, which was set to go into effect August 6. Citing the need for additional time to revise the standardized notification form that hospitals will need to use to notify patients about the financial implications of being assigned to observation services, CMS moved back the start date for the requirement in the 2017 IPPS final rule to “no later than 90 days,” after the final version of the form is approved.
The American Case Management Association and National Board of Case Management recently completed the 2016 Case Manager Practice Analysis Study to support the Accredited Case Manager credentialing examination, according to a press release.
Observation services are an ongoing point of confusion for hospitals and patients, many of whom have become fearful of out-of-pocket costs and SNF coverage eligibility associated with outpatient observation services. Developing a workflow to comply with the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act and the Medicare Outpatient Observation Notice (MOON) is essential and is intended to help hospitals ease patients' concerns by clearing up the implications of observation.
There's good news and bad news on the 2-midnight rule front. The good news: CMS has put short-stay inpatient audits related to the 2-midnight rule on hold as of May 4. The bad news: This isn't a free pass, and it isn't going to last.
Assigning the correct patient status is important not only to ensure that the hospital gets accurate payment for a patient stay, but also to ensure that the patient receives access to the postacute benefits to which he or she is entitled.
One of the more challenging aspects of a case manager's job is helping to ensure a patient successfully transfers from the hospital to the next level of care. Under a set of proposed revisions to Medicare's Conditions of Participation (CoP) announced in November 2015.
