President Barack Obama signed the Medicare Access and CHIP Reauthorization Act (MACRA) into law in April, and with its passage, repealed the highly criticized sustainable growth rate (SGR) formula.
Getting Physicians Behind a Clinical Documentation Initiative
Physicians are fervent believers in the goals of clinical documentation initiatives, and they want a CDI at their hospital to work — at least in theory. Trouble is, with many hospitals still in the early developmental stages of their CDI programs, physicians are seeing little net benefit for their individual practice or their patients, even if a CDI is meeting the goals of system administrators. The return on investment for the physicians' time just isn't there yet.
CMS extends enforcement delay for 'two-midnight' rule
The CMS has extended its enforcement delay for the controversial "two-midnight" rule governing short hospital stays to fall in line with recently proposed changes to the policy.
What healthcare executives should know about ICD-10
Despite efforts by critics to stave off the transition to the ICD-10 coding system, the mandated October 1, 2015 deadline became a near certainty when the American Medical Association (AMA) signaled a cooperative arrangement with the Centers for Medicare and Medicaid Services (CMS) in early July to assist practitioners in making the switch.
CMS recently published its CY 2016 Hospital OPPS and ASC Proposed Rule in which it proposes to create a new exception under the 2-Midnight Rule. The 2-Midnight Rule provides that hospital inpatient admissions are generally payable under Medicare Part A if the admitting physician (or other admitting practitioner) expected the patient to require a hospital stay that crossed two midnights and the medical record supports that reasonable expectation.
Healthcare providers are expressing support for legislation overwhelmingly approved by Congress requiring hospitals to notify Medicare patients when they are receiving observation care but have not been admitted.
The U.S. Senate unanimously approved legislation Monday night requiring hospitals across the nation to tell Medicare patients when they receive observation care but have not been admitted to the hospital. It’s a distinction that’s easy to miss until patients are hit with big medical bills after a short stay.
To address an increased demand for outpatient services and a surplus of inpatient beds, one Texas hospital plans to create a short-stay center--and it's a move that other other hospitals across the country may want to consider.
The CMS floated a slate of tweaks to Medicare's quality- and safety-reporting requirements in its sweeping proposed rule for 2016 inpatient hospital rates issued last week.
More warning signals are flashing on the health industry's readiness for the upcoming switch to ICD-10 diagnostic and procedure codes—this time from a key revenue-cycle-management sector.