Special Bulletin
The federal agency has recommended that healthcare workers self-report symptoms and not work if ill. EDITOR’S NOTE: On March 5, the Centers for Disease Control and Prevention (CDC) held a call to update the provider community on the latest guidance related to COVID-19. During the call, several CDC physicians described…
The nation’s largest healthcare conference has been canceled amid the growing threat. The deadly coronavirus (COVID-19) has resulted in the cancellation of HIMSS20, the 2020 healthcare IT conference initially scheduled to take place next Monday in Florida, according to an announcement on the association’s website. “Following reports from the WHO…
March 5, 2020
CMS Suspends Non-Emergency Inspections to Free Up Resources for Coronavirus Response
By Mark Spivey Global cases are approaching 100,000 as the U.S. braces for the worst. The Centers for Medicare & Medicaid Services (CMS) has suspended non-emergency facility inspections nationwide as a measure to free up resources to focus more acutely on the COVID-19 respiratory virus, officials announced on Wednesday. “CMS is committed to…
February 11, 2020
News Alert: NGS Will Not Remove Observation Hours from Claims for MOON Errors
By Chuck Buck CMS says MOON errors will not affect billing/payment. EDITORS NOTE: This article is an update from last week's article Erroneous Guidance by NGS Could Pose Problems for Hospitals. Observation hours will not be removed from claims if hospitals fail to accurately complete and deliver to patients the Medicare Outpatient Observation…
Are MACs going rogue? According to a webinar held last week, NGS, the Medicare Administrative Contractor (MAC), has taken the targeted probe-and-educate audits (TPE) to an area one would never expect: the proper completion and delivery of the Medicare Outpatient Observation Notice (MOON), the Centers for Medicare & Medicaid Services…
February 3, 2020
News Alert: OIG Auditing of Post-Acute Transfer Claims Roils Hospitals
By Chuck Buck The OIG has instructed MACs to recoup the entire DRG payment on claims dating back to 2016. EDITOR’S NOTE: The RACmonitor special bulletin of Jan. 30, “News Alert: Widespread Recoupments of Incorrect Post-Acute Transfer Claims Have Begun,” is prompting alarm among hospitals, as evidenced by the response from Dr. R.…
January 30, 2020
News Alert: Widespread Recoupments of Incorrect Post-Acute Transfer Claims Have Begun
By Chuck Buck At issue: hospital overpayments of $54.4 million. There has been recent talk on an online user group that many hospitals have had recoupments of payment for inpatient admissions from 2016 to 2018 due to an “incorrect discharge status code.” This appears to be in response to a November 2019 audit…
January 9, 2020
CMS Releases New MOON, Important Message from Medicare, and Detailed Notice of Discharge
By Chuck Buck Same old New MOON, but potential problems appear in two of the other three new forms. All federal forms require periodic review and reapproval by the Office of Management and Budget (OMB). The approval is indicated on the form by a unique number and an expiration date. The Centers for…