Posted by Jason Greis on January 22, 2009 under Articles | 
The Centers for Medicare and Medicaid Services (“CMS”) has issued three Coverage Decision Memorandums establishing National Coverage Determinations (NCDs) that “wrong surgeries” — surgeries on the wrong body part, surgeries on the wrong patient, and the wrong procedure — are not covered by Medicare. The wrong body party, wrong patient, and wrong procedure NCDs are effective January 15, 2009 and apply to all provider types and coverage under both Part A and Part B. Read More...
Tags: brent rawlings, cms, coverage decision memo, greisguide, GreisGuide to LTACHs, hospital, ipps, Joint Commission, LTACH, LTCH, medicare, ncd, NQF, value-based purchasing, wrong part, wrong patient, wrong procedure
Posted by Jason Greis on January 21, 2009 under Articles |
The Department of Health and Human Services (HHS) issued a final regulation on Jan. 15, 2009 giving health care providers (including LTACHs) and plans two additional years-until October 1, 2013-to adopt the new health care coding system, the International Classification of Diseases, Tenth Revision (ICD-10). Under a proposed rule issued in August 2008, health care providers would have been required to adopt ICD-10 by October 2011. This new coding system greatly expands on the ICD-9-CM codes sets, which were developed nearly thirty years ago. HHS agreed to delay the compliance deadline in order to accommodate the concerns (generally concerns regarding implementation and training costs) of over 3,000 commenters urging that more time is needed for effective industry implementation of the new coding system. Read More...
Tags: 2013, abuse, altha, Centers for Medicare and Medicaid Services, cms, covered entity, federation of american hospitals, fraud, greisguide, GreisGuide to LTACHs, Health Information Management Association, hipaa, hospital, icd-10, International Classification of Diseases, jason greis, LTACH, LTCH, value-based purchasing
Posted by Jason Greis on January 19, 2009 under Whitepapers |
I have recently spoken with a number of LTACH administrators and CEOs interested in entering into compensated call coverage arrangements or expanding the scope of their existing compensated call coverage programs with hospitalists, intensivists, and other physicians. Call coverage arrangements generally provide an excellent opportunity for LTACHs to align hospital and physician patient care objectives and for creating strategic long-term relationships with physicians in the community. These arrangements, however, also have the potential to adversely impact a hospital’s bottom line and raise a number of practical legal and business considerations discussed below that should be carefully considered. Read More...
Tags: 07-10, activation fee, advisory opinion, call coverage, double dipping, fair market value, fmv, greisguide, GreisGuide to LTACHs, hospital, hospitalist, intensivist, jason greis, LTACH, LTCH, medical staff, oig, on-call, patient, payor, physician, pulmonologist
Posted by Jason Greis on January 16, 2009 under Industry News |
Heartland Health plans to open a 41-bed HwH in St. Joseph, Missouri in early 2009. Read More...
Posted by Jason Greis on January 9, 2009 under Articles |
This listserve is a continuation of a series of listserves updating McGuireWoods clients on developments surrounding the Centers for Medicare and Medicaid Services (CMS) claims and activity Recovery Audit Contractors (RACs). Future updates will be provided on the McGuireWoods listserve as they become available. For a more comprehensive discussion of RACs, please see the white paper Medicare Recovery Audit Contractors (RACs): What Providers Need to Know and How to Prepare. Read More...
Tags: appeal, brent rawlings, Centers for Medicare and Medicaid Services, cms, error, greisguide, GreisGuide to LTACHs, hospital, ltac, LTACH, LTCH, Medicare Recovery Audit Contractors (RACs): What Providers Need to Know and How to Prepare, RAC, recovery audit contractor
Posted by Jason Greis on January 7, 2009 under Articles |
The Agency for Healthcare Research and Quality (AHRQ) has commissioned a review of Negative Pressure Wound Therapy (NPWT) devices as part of the Technology Assessment Program. The purpose of this review is to provide information to the Centers for Medicare & Medicaid Services (CMS) for consideration in Healthcare Common Procedure Coding System (HCPCS) coding decisions. The findings of this review will likely have reimbursement implications for the LTACH community. The Medicare Improvements for Patient and Providers Act of 2008 (MIPPA) calls for the Secretary of Health and Human Services to perform an evaluation of the HCPCS codes for NPWT devices. Read More...
Tags: Agency for Healthcare Research and Quality, AHRQ, cms, device, greisguide, GreisGuide to LTACHs, hcpcs, Healthcare Common Procedure Coding System, hospital, jason greis, ltac, LTACH, LTCH, MIPPA, negative pressure wound therapy, npwt
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