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Archive for December, 2010

IOM to Hold Meeting on GAF

Thursday, December 23rd, 2010

The Institute of Medicine (IOM) Committee on Geographic Adjustment Factors (GAF) will hold an open session on January 20th to explore issues related to the geographic adjustment factors used by Medicare. Presenters will offer perspectives on the adjustment factors and will examine their influence on health care access, quality, and the health care workforce in different geographic areas. The committee is particularly interested in views on the accuracy of the data sources and methods used to calculate the hospital wage index and geographic practice cost indices, and how they can be improved. The meeting also will be webcast. Hospitals are invited to submit comments for the meeting to geographicadjustmentfactors@nas.edu.

For more on the meeting or to register to attend, visit www.iom.edu

Revised ICD-10 Mappings Posted

Monday, December 20th, 2010

The Centers for Medicare & Medicaid Services (CMS) has revised its General Equivalence Mappings (GEMs) for the ICD-10-CM diagnosis and the ICD-10 procedure coding system (PCS). The GEMs are used to translate data between the ICD-9 coding system and ICD-10, which will replace ICD-9 on October 1, 2013. The Patient Protection and Affordable Care Act (ACA) required the Department of Health and Human Services (HHS) to revise the GEMs and adopt the revised GEMs as the standard mappings before January 1.

These can be viewed at https://www.cms.gov/ICD10/11b1_2011_ICD10CM_and_GEMs.asp#TopOfPage

AHA/ACC/HRS Update AF Management Guidelines

Monday, December 20th, 2010

The American Heart Association (AHA), American College of Cardiology (ACC), and the Heart Rhythm Society (HRS) have updated the 2006 guidelines for the management of patients with atrial fibrillation (AF). The full-text guidelines published in 2006 remain current with the exception of the recommendation presented in the new document.

The guidelines are available at http://www.hrsonline.org/Policy/ClinicalGuidelines/2010-AF-Guidelines-Update.cfm

President Signs Bill to Delay Physician Pay Cuts

Thursday, December 16th, 2010

On December 15, President Obama signed into law the Medicare and Medicaid Extenders Act, which delays a 25% Medicare payment reduction for physicians and extends several expiring hospital-related payment provisions until January 2012. Among the bill’s provisions are measures that provide an exceptions process for Medicare therapy caps, extend the outpatient “hold harmless” payment provision, restore to children’s hospitals discounts for orphan drugs, and renew the reclassification program that allows hospitals to seek improvements in their Medicare wage index. The $19.2 billion bill will be paid for by shifting costs from the health care reform law.

The bill can be found at <http://www.gpo.gov/fdsys/pkg/BILLS-111hr4994enr/pdf/BILLS-111hr4994enr.pdf>

EP Specialty Code Approved

Monday, December 13th, 2010

A new physician specialty code for cardiac electrophysiology (EP) has been approved by the Centers for Medicare & Medicaid Services (CMS). The new specialty code designation is “23″ and it will allow CMS to collect data on the work and practice expenses of EPs. This will more accurately measure use of physician resources and track patient treatment across episodes of care. The new designation code goes into effect of April 4, 2011.

For more information, go to http://www.hrsonline.org/Policy/ep_designation_announcement.cfm

MedPAC Considers Payment Updates for 2012

Tuesday, December 7th, 2010

The Medicare Payment Advisory Commission (MedPAC) is considering drafting recommendations to Congress that would provide a full market basket update of 2.6% to hospital inpatient payments in fiscal year 2012, with a 1.6% reduction to reflect mandatory documentation and coding offset. This would result in a final update of 1.0%. MedPAC is also considering a 1.0% update for outpatient hospital and physician payments. MedPAC’s draft recommendations may be revised before the commission votes in January.

More information is available at http://www.medpac.gov/.