CMS pledging improved healthcare quality and expanded access for patients. The release of the Inpatient Prospective Payment System (IPPS) proposed rule for the 2020 fiscal year came with a bit of branding. “Rethinking Rural Health” and “Unleashing Innovations” were the two catchy slogans unveiled by the Centers for Medicare &…
April 18, 2019
NEWS ALERT: CMS Posts 2020 IRF Proposed Rule
Proposed rule calls amending regulations clarifying the determination as to whether a physician qualifies as a rehabilitation physician is made by the IRF. The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule for the inpatient rehabilitation facility (IRF) prospective payment system for the fiscal year 2020.…
October 18, 2018
Inpatient Admission Order Regulations Continue to Confound
CMS removed the admission order as a condition of payment effective Oct. 1, 2018. The change in the 2019 Inpatient Prospective Payment System (IPPS) Final Rule concerning the inpatient admission order has created more controversy than I expected. When I read the proposed and final rules, wrote my RACmonitor articles…
October 18, 2018
The Next Big RAC Audit Could Be Spinal Fusions
Know the risk, evaluate your exposure. The FY 2019 Inpatient Prospective Payment System (IPPS), which includes the Medicare Severity Diagnosis Related Groups (MS-DRGs), went into effect Oct. 1, 2018. There is one area that did not get much attention regarding the changes that were included in this year’s update: spinal…
September 20, 2018
Medicare and Medicaid Regulations Suspended During Natural Disasters
CMS provides Medicare waivers for providers dealing with natural disasters. I live in North Carolina, and as most of you have seen on the news, we just underwent a natural disaster. Its name is Hurricane Florence. Our Governor has declared a state of emergency, and this declaration is extremely important…
September 20, 2018
Admission Order Regulation Change Brings Relief – And Uncertainty
2019 IPPS removes requirement for authentication of admission orders prior to discharge. EDITOR’S NOTE: This is the first installment of a two-part series. When the Centers for Medicare & Medicaid Services (CMS) finalized the 2019 Inpatient Prospective Payment System (IPPS) Final Rule, hospitals across the country breathed a deep sigh…
August 30, 2018
QIOs Urged to Stop Denials for Lack of Timely Authentication
I have whined in a previous RACmonitor enews article about how the importance given to the admission order in today’s healthcare industry makes absolutely no sense. It’s not an order for a medication or a test, wherein if it is transcribed incorrectly, the patient could be physically harmed. The admission…
Experts warn of challenges for IRFs in FY 2020. The final rule for fiscal year (FY) 2019 for Inpatient Rehabilitation Facility (IRF) Payment has been published and there are a few changes between the proposed rule and the final one. What might be of even more interest to IRFs are…
August 3, 2018
News Alert: CMS Posts 2019 IPPS Final Rule, Heralding Major Changes to Admission Order Regulation
Changes to the inpatient admission order regulations are significant The Centers for Medicare & Medicaid Services (CMS) has posted the 2019 Inpatient Prospective Payment (IPPS) Final Rule, which changes inpatient admission order regulations. The Final Rule was published Thursday in the Federal Register. “The inpatient admission order regulations are a…
Recoupment and one-day inpatient admission for total knee replacement. EDITOR’S NOTE: The following is a summary of a broadcast segment on Monitor Monday, May 7 by the author. While we are still trying to make sense of what the Centers for Medicare & Medicaid Services (CMS) meant with its proposal…
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