Special Bulletin

Same-day discharge shown to be safe; Society guides physicians to choose correct status Same-day discharge following a percutaneous coronary intervention (PCI) under certain conditions has gained the consensus endorsement of the Society of Cardiovascular Angiography and Interventions (SCAI). The society recently published an update to its consensus statement on length…
Orthopedic surgeons are upset with various interpretations of regulations on total knee replacement coming from CMS. The saga of determining the proper status for Medicare total knee replacement (TKR) patients continues. As many people know, you do not want to upset a surgeon. And it appears that the Centers for…
Those investigating healthcare entities instructed to stick to statutes and regulations The U.S. Department of Justice (DOJ) has issued another memo likely to help healthcare providers avoid potentially unfair government investigations.  The Jan. 25 memo from Associate Attorney General Rachel Brand to the heads of all civil litigation components and U.S.…
CMS requires that all total knee replacements performed on fee-for-service Medicare beneficiaries are performed in a hospital.  AUTHOR’S NOTE: Since the release of the 2018 Outpatient Prospective Payment System (OPPS) Final Rule, there have been many varying opinions on how to determine the proper status for patients undergoing total knee…
Without congressional action, new therapy caps became effective Jan. 1, 2018. Going into 2018, Medicare beneficiaries will have therapy benefits capped at $2,010 for physical therapy (PT) and speech-language pathology (SLP) combined, and the same limit for occupational therapy. Congress recessed for the holiday break without addressing the expiration of…
The CMS announcement will be discussed in a conference call on Jan. 9, 2018. Healthcare providers and suppliers with fewer than 500 appeals pending at the Office of Medicare Hearings and Appeals (OMHA) and the Medicare Appeals Council could be eligible to participate in a new low-volume appeals (LVA) settlement…
Lexington Regional Health Center prepares for the long winter night on Christmas Eve. It won’t be dinner as usual tonight. It is promised to be more festive and elegant, with oyster and potato soup as options. Dressed in scrubs and some wearing their whitecoats, they will shuffle into the cafeteria…
New RAC issues proposed for auditing appear to baffle the author As promised, the Centers for Medicare & Medicaid Services (CMS) has posted its December 2017 list of issues that are being considered for Recovery Audit Contractor (RAC) auditing. And as expected, a few of the proposed issues appear a…