CMS proposes fiscal year 2015 payment and policy changes for Medicare SNFs
Overview On May 1, 2014, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule [CMS-1605-P] outlining proposed Fiscal Year (FY) 2015 Medicare payment rates for skilled nursing...
View ArticleTwo organizations fined $4.8 million for HIPAA violations
by Jaclyn Fitzgerald, Editor OCR recently slapped two organizations with the largest monetary penalty for HIPAA violations to date: $4.8 million. New York and Presbyterian Hospital (NYP) and Columbia...
View ArticleAspirin inhibits chronic wound healing rates
Long-term care professionals might want to opt for non-aspirin pain relievers for residents with chronic wounds, as researchers have discovered that aspirin appears to suppress healing. The study was...
View ArticleQ&A: Can we charge fluoroscopy during endomyocardial biopsies?
Q: Our physicians have started performing endomyocardial biopsies on an outpatient basis. They insert the catheters into the right ventricle using fluoroscopy. We have added the charge lines to our...
View ArticleCMS nixes ICD-10 end-to-end testing
by Jaclyn Fitzgerald, Editor The announcement that ICD-10 would be delayed once again made waves throughout the healthcare industry. In the wake of the passing of the Protecting Access to Medicare Act...
View ArticleQ&A: Why can’t we bill ventilator management in the ED?
Q: An auditor recently reviewed our outpatient ED claims and told us that we cannot report CPT® code 94002 (ventilation assist and management, initiation of pressure or volume preset ventilators for...
View ArticleQ&A: Why do we get denials on noninvasive vascular studies?
Q: We are receiving denial of our bilateral noninvasive vascular studies, like ankle/brachial indices. We sometimes perform a bilateral study of the upper and lower extremities and report two...
View ArticleRevenue from OIG audits expected to drop by almost $1 billion
Revenues from Department of Health and Human Services Office of Inspector General audits and investigations department for the first half of fiscal 2014 are expected to drop almost $1 billion from the...
View ArticleCMS, ONC propose additional changes to the EHR Incentive Programs
by Jaclyn Fitzgerald, Editor CMS and ONC recently published a proposed rule in the Federal Register that would offer enhanced flexibility for organizations using certified EHR technology (CEHRT) and...
View ArticleCMS releases interim version of OASIS in wake of ICD-10 delay
CMS recently announced that a new, hybrid version of OASIS will take effect on January 1, 2015—three months later than the original implementation date—to accommodate the latest ICD-10 delay.The new...
View ArticleQ&A: Has billing for venipuncture changed in 2014?
Q: We have been watching our payments from Medicare since all the lab bundling was instituted in the 2014 OPPS final rule. We noticed that we are not receiving $3 for venipuncture any longer on any...
View ArticleAHA sues HHS over RAC review delays
by Jaclyn Fitzgerald, Editor The American Hospital Association (AHA) and three hospitals took aim at Recovery Audit Contractors’ (RAC) denials and appeals process by filing a lawsuit against HHS May...
View ArticleResearchers Commit $30 Million to Fall Prevention Study
Fall-related injuries continue to plague the aging population, but researchers are striving to combat the ubiquitous problem through a new five-year, $30 million study.The Patient-Centered Outcomes...
View ArticleQ&A: When can we use CPT code 93623 with electrophysiology studies?
Q: We perform electrophysiology (EP) studies in our catheterization lab for outpatients. Many times this involves infusing a drug and then stimulating and pacing the heart. We also do this with our...
View ArticleConcentra in hot water over HIPAA breach--again
by Jaclyn Fitzgerald, Editor Just months after HHS announced it entered into a $1.7 million resolution agreement with Concentra Health Services, a national healthcare company, for HIPAA violations, the...
View ArticleCMS to surveyors: Certain infection control breaches warrant referral to...
CMS recently issued a memorandum to state survey agency (SA) directors outlining specific infection control breaches that, when identified by either state surveyors or accrediting organization (AO)...
View ArticleQ&A: What items will receive pass-through payment in July?
Q: Will any new items receive pass-through payment beginning in July? A: Yes, CMS granted is a new brachytherapy source, cesium-131 chloride solution, pass-through status beginning July 1, 2014, and...
View ArticleSNFs and Rehab facilities should receive same payments
Skilled nursing facilities and inpatient rehabilitation facilities should receive the same payments for treating certain conditions, the Medicare Payment Advisory Commission recommended in its latest...
View ArticleAHA releases quarterly RACTrac survey results
by Jaclyn Fitzgerald, Editor The American Hospital Association’s quarterly RACTrac survey revealed that hospitals appealed 50% of claims denied by Recovery Audit Contractors (RAC) during the first...
View ArticleLegislators send letter to HHS Secretary contesting the ACA's employer mandate
Senator Tammy Baldwin (D-Wisconsin) and Representative Ron Kind (D-Wisconsin) recently sent a bicameral letter to Sylvia Matthews Burwell, the new Secretary of Health and Human Services (HHS), on the...
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