The Centers for Medicare and Medicaid Services (“CMS”) published a proposed rule on April 30th that would increase Medicare inpatient reimbursements to hospitals for fiscal year 2015. The proposed rule would increase Medicare inpatient reimbursements for acute care hospitals by
OIG recommends equal Medicare payment rates for surgical procedures performed in hospital outpatient departments and ambulatory surgery centers
The Department of Health and Human Services’ Office of Inspector General (“OIG”) has released a report in which it recommends that the Centers for Medicare and Medicaid Services (“CMS”) equalize payment rates for surgical procedures performed in hospital outpatient departments
Medicare publishes physician-specific payment data, industry fears FCA claims will follow
In what is being touted as an unprecedented attempt at transparency, Medicare released millions of physician reimbursement records on April 9, 2014. According to the Center for Medicare and Medicaid Services (“CMS”), the data has been released “as part of
OIG terminates opinion, finding $1 changes in discounts may induce improper referrals
The Department of Health and Human Services Office of Inspector General (“OIG”) has terminated an advisory opinion (No. 11-18) that found a low risk of improper inducement of referrals resulting from a fee arrangement in an electronic patient-referral service.
The
GAO report calls out regulators: lack of standards impeding use of E-records systems
The US Government Accountability Office (“GAO”) recently surveyed providers about challenges they have faced while using Electronic Health Records (“EHR”) Systems. While the government encourages EHR use through EHR meaningful use incentive payments, providers reported issues with insufficient standards, concerns
House and Senate pass bill to extend current Medicare physician payment rates
On March 27, the House of Representatives passed H.R. 4302, “Protecting Access to Medicare Act of 2014,” a bill to extend current Medicare physician payment rates until March 2015. On March 31, the Senate followed suit, passing the so-called “doc
CMS announces reopening of claims denied under two midnight rule
On February 24, 2014, the Centers for Medicare and Medicaid Services (“CMS”) directed Medicare administrative contractors (“MACs”) to reopen all claims denied under the “two midnight” rule between October 1, 2013 and January 30, 2014.
The “two midnight” rule, issued
CMS offers new resources and guidance on two-phase approach to Sunshine Act reporting
The CMS has posted new resources to its “Open Payments” website to clarify its recently announced two-stage approach to registration and data submission. These resources include:
CMS delays data submission at least 30 days
In a posting to its Open Payments website (through which it communicates about the Sunshine Act), CMS announced that the March 31 data submission deadline (originally set under the statute for March 31, 2013 and delayed by rule to March
Estimates of ICD-10 roll-out costs rising, says AMA report
The American Medical Association (“AMA”) has released a new report, prepared by Nachimson Advisors, that estimates the cost of implementing the ICD-10 medical coding system. The ICD, short for the International Classification of Diseases and Health Problems, is a list