The Centers for Medicare & Medicaid Services (CMS) has identified an issue related to missing discharge assessments for inactive residents. On August 23, 2013, CMS issued a survey and certification memorandum
Medicare released a proposed rule in the Federal Register , “Medicare Program; Part B Inpatient Billing in Hospitals,” in March 2013. That proposed rule, in combination with the ruling for Part A to B denial rebilling—which was effective immediately on publication—is intended to get a handle on a huge area of heartburn for hospitals.
Although the hospital industry has weathered difficult conditions in the past, widespread challenges continue to push change within the sector. Widely reported regulatory changes and the need to obtain operational and financial scale and scope in the health care industry have combined with other auxiliary issues to compound the need for further change within the sector
The results of recent recovery audit contractor (RAC) automated reviews of hospital services were outlined in the January 2013 Medicare Quarterly Provider Compliance Newsletter, Volume 3, Issue 2 . Among the hot topics discussed was a significant issue for physician providers: the RACs identified that inappropriate current procedural terminology (CPT) codes were being assigned for related professional evaluation and management (E/M) services “rendered in swing bed facilities (with nursing facility levels of care)” in the same episode of care as an acute inpatient stay, when the patient was not “on a leave of absence from the hospital.” Specifically, inpatient hospital CPT codes, i.e
The Patient Protection and Affordable Care Act (PPACA) introduced various ways to strengthen primary care by improving care coordination, making it easier for clinicians to work together and helping clinicians spend more time with their patients. One such program is the Comprehensive Primary Care (CPC) initiative.
Federal health care reform continues to spur consolidation and integration among hospitals in the U.S. One example is the acquisition of 36-bed Cumberland River Hospital in Celina, Tennessee, by 247-bed Cookeville Regional Medical Center in Cookeville, Tennessee