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Archive for September, 2008

Revised Timeline for RAC Rollout Announced

Wednesday, September 17th, 2008

The Centers for Medicare & Medicaid Services (CMS) Office of Financial Management has announced a revised timeline for the nationwide rollout of the permanent recovery audit contractor program (RACs). They will not begin education and outreach to providers in the first round of states until October 1, the second round until March 1, 2009, and the third round until at least August 1, 2009. CMS still intends to announce the permanent RACs by October 1.

For more information, visit http://www.cms.hhs.gov/RAC/01_Overview.asp.

AHRQ Releases Hospital Surge Capacity Tool

Wednesday, September 17th, 2008

The Agency for Healthcare Research and Quality (AHRQ) has released a Web-based tool to help hospitals and emergency planners estimate the resources needed to treat an influx of patients in a disaster. The Hospital Surge Model can estimate the number and flow of casualties needing medical attention for scenarios consistent with the Homeland Security Counsel’s National Planning Scenarios.

The tool can be access at http://hospitalsurgemodel.ahrq.gov/.

Regional MAC Contract Awarded

Wednesday, September 17th, 2008

The Centers for Medicare & Medicaid Services (CMS) has named First Coast Service Options Inc. (FCSO) the Medicare Administrative Contractor (MAC) for Part A and B claims payment in Florida, Puerto Rico and the U.S. Virgin Islands. FCSO will serve for up to five years as the point of contact for fee-for-service claims processing and payment for hospitals, skilled nursing facilities, physicians and other health care practitioners, assuming full responsibility by March 2009. The contractor is the ninth of 15 Part A/B MACs to be named under the Medicare Modernization Act, which called for all Medicare fiscal intermediaries and carriers to be replaced by MACs by 2011.

Check the press releases at http://www.cms.hhs.gov/apps/media/press/release for more information.

Hospital Compare Data Updated

Wednesday, September 17th, 2008

The Hospital Quality Alliance (HQA) has updated the Hospital Compare web site with fourth-quarter 2007 data. The updated site provides data on heart attack, heart failure, pneumonia, surgical and pediatric asthma care for patients discharged from participating hospitals in 2007, as well as HCAHPS data on patient experiences with care.

The website is available at http://www.hospitalcompare.hhs.gov/.

CMS Announces 2009 Medicare Premiums, Deductibles and Co-Pays

Wednesday, September 17th, 2008

The Centers for Medicare & Medicaid Services (CMS) has announced that the Medicare Part A hospital insurance deductible will increase by $44 in 2009 to $1,068. After the first 60 days of Medicare-covered inpatient hospital care, beneficiaries pay daily coinsurance, which in 2009 will increase by $11 for days 61-90 to $267 per day and by $22 after 90 days to $534. The Medicare Part B monthly premium and the annual deductible will remain the same at $96.40 and $135, respectively.

A fact sheet can be viewed at http://www.cms.hhs.gov/apps/media/press/factsheet.

Medicare Guide for Technology Innovators Issued

Wednesday, September 17th, 2008

The Centers for Medicare & Medicaid Services (CMS) has issued a guide to assist technology innovators in navigating Medicare’s coverage, coding and payment requirements. The CMS Council developed the guide for Technology and Innovation, a working group established by the Medicare Modernization Act of 2003.

The guide can be accessed at http://www.cms.hhs.gov/CouncilonTechInnov/ Downloads/InnovatorsGuide8_25_08.pdf.

DOJ Issues Revised Guidelines for Prosecuting Fraud

Wednesday, September 17th, 2008

The Department of Justice (DOJ) has issued revised guidelines for prosecuting corporate fraud, including cases alleging violations of the False Claims Act. Under the revised guidelines, corporations will no longer be required to waive attorney-client privilege or work product protections to receive credit for cooperating with the department. The revised guidelines make clear that the receipt of credit for cooperation depends on full disclosure of the relevant facts. In addition, the guidelines instruct prosecutors not to consider a corporation’s advancement of attorneys’ fees to employees when evaluating cooperativeness.

The guidelines are available at http://www.usdoj.gov/opa/documents/corp-charging-guidelines.pdf.