June 10, 2016

Looking Back, Moving Forward: The Weekend Edition for Saturday, June 11, 2016

By

Welcome to the weekend and thanks for checking in. 

We’re bringing you the news from the past week as well as providing you with a look at the week ahead.

LOOKING BACK THIS PAST WEEK 

JW Modifier Postponed Until January 2017

It’s now official. The JW modifier implementation delay was confirmed on Thursday with the released of Transmittal 3538 The postponement will be, in fact, Jan., 2017. 

Physicians and hospitals will be required to use of the JW modifier to identify discarded drugs and biologicals when processing Part B claims for drugs and biologicals, except Competitive Acquisition Program (CAP) drugs and biologicals.

Hospitals and physicians, however, should be aware that this delay is at the the Centers for Medicare & Medicaid Services (CMS) level.  Potential remains at the regional contractor level for implementation of the July 1 requirement.  Transmittal 3538 clearly states that as of Jan. 1, 2017, that CMS is removing the contractors’ discretion with determinations regarding JW modifier and will move forward with the previously announced requirements.

Introducing Central Asset Recovery Professional

The New York Times reported that television comedian John Oliver, host of Last Week Tonight on HBO, told his audience that he had formed a company called Central Asset Recovery Professionals —otherwise known as CARP. 

The Times said Oliver purchased $14.09 million worth of medical debt for less than $60,000. The portfolio, according to the Times included approximately 9,000 names of individuals, their addresses and Social Security numbers. He then gave the debt away. 

BFCC-QIO Confusion Continues

An email this week points to the confusion swirling about the QIO temporary suspension of short stay reviews.

Chuck, 

Do you have any further information about why the second round of requests are going out from KEPRO even though CMS and KEPRO websites say the reviews are on hold?

Ronald Hirsch, MD responded:

“QIO requests records for lots of reasons so I suspect the charts may be for another issue, like DRG or quality or a complaint.”

COMING ATTRACTIONS 

New Strategies That Are Removing Rural Health from Life Support

Presented By Janelle Ali-Dinar, PhD
Thursday, June 23
1:30-2:30 PM ET

Rural healthcare authority Janelle Ali-Dinar, PhD, is producing a webcast for RACmonitor readers on the state of rural facilities. The presentation will address rural precision medicine, advanced diagnostics, and population health methods/services of treatment to bridge the gap of care for the most critical needs of rural populations including chronic disease management, opioid abuse, and medication management and premature deaths. Register here.

esMD: The Best News Yet from CMS

Complimentary Special Edition Broadcast
Sponsored by VYNE
Tuesday, June 28
1:30-2:30 PM ET

esMD, electronic submission of medical documentation, can cut turnaround time, reduce labor and hard costs, and even begin to realize significant financial savings. This exclusive webcast will feature Joyce Davis, deputy director for the Electronic Submission of Medical Documentation Program in the Office of Financial Management Provider Compliance Group. Rudy Braccili, Jr., MBA, executive director of revenue cycle services for Boca Raton Regional Hospital in Boca Raton, Fla. and Nicole Smith, vice president of operations and government services at Vyne. Register here.

Incident-To Services That Can Hemorrhage Your Facility and Physicians

Presented By Michael G. Calahan, PA, MBA
Thursday, July 14
1:30-2:30 PM ET 

Incident-to services are increasing, making them "low-hanging fruit" for federal auditing entities. Getting incident-to rules wrong can cost your facility or physician practice hundreds of thousands of dollars during federal audits. Learn the top ten federal audit targets have could ravage your potential revenue. Register here.

Chuck Buck

Chuck Buck is the publisher of RACmonitor and is the program host and executive producer of Monitor Monday.

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