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Archive for August, 2012

Comments on Proposed ICD-10 Readiness Assessment Sought

Friday, August 10th, 2012

The Centers for Medicare & Medicaid Services (CMS) is accepting comments until October 9th on a proposed ICD-10 readiness assessment. This assessment will be used by CMS to help understand each sector’s progress toward compliance, and to determine what educational tools and resources will be necessary to achieve it. In April, the Department of Health and Human Services (HHS) proposed delaying the ICD-10 implementation deadline by one year, to October 1, 2014.

More information can be viewed at http://www.gpo.gov/fdsys/pkg/FR-2012-08-10/pdf/2012-19694.pdf

EFT and ERA Rule Published

Tuesday, August 7th, 2012

The Centers for Medicare & Medicaid Services (CMS) released an interim final rule adopting operating rules for electronic transfer of health care funds (EFT) and electronic remittance advice (ERA) under the Health Insurance Portability and Accountability Act (HIPAA). Health plans and other HIPAA-covered entities, including hospitals, must comply with the operating rules by January 1, 2014. When combined with an earlier rule adopting federal standards for electronic fund transfer and remittance advice, CMS estimates the operating rules will save between $2.7 billion and $9 billion in administrative costs over 10 years by reducing manual administrative processes for physicians, hospitals and health plans.

The rule can be accessed at https://www.federalregister.gov/articles/2012/08/10/2012-19557/administrative-simplification-adoption-of-operating-rules-for-health-care-electronic-funds-transfers.

Grants Awarded to Train Veterans

Monday, August 6th, 2012

The Health Resources and Services Administration (HRSA) has $2.3 million in grants to help 12 schools train returning veterans as primary care physician assistants (PAs) or PA educators. These grants will help ensure veterans can use their military medical training and get jobs serving patients. The five-year grants are funded by HRSA’s Physicians Assistant Training in Primary Care Program.

More information regarding the training program is available at http://bhpr.hrsa.gov/grants/medicine/patpc.html.

Medicare Releases 2013 IPPS and LTCH PPS Final Rule

Thursday, August 2nd, 2012

On August 1, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates fiscal year (FY) 2013 Medicare payment policies and rates for their inpatient prospective payment system (IPPS) and long-term care hospitals (LTCH) prospective payment system (PPS). The final rule implements key elements of the Affordable Care Act’s hospital value-based purchasing and hospital readmissions reduction programs. The rule also advances efforts to tie Medicare payments to quality health care across the delivery system, with new quality reporting measures for general acute care hospitals in FY 2015 and FY 2016. In addition, the rule established new reporting and other requirements for the Ambulatory Surgical Center Quality Reporting (ASCQR) Program.

Under the final rule, payment rates to general acute care hospitals will increase by 2.8% in FY 2013. The 2.8% is the net result after the market basket update, improvements in productivity, a statutory adjustment factor and adjustments for hospital documentation and coding changes. The rate increase, together with other policies in the final rule, would increase Medicare’s operating payments to acute care hospitals by approximately 2.3% in FY 2013. CMS projects that total Medicare spending on inpatient hospital services will increase by about $2 billion in FY 2013 relative to FY 2012. Long-term care hospitals (LTCHs) will receive a net payment increase of 1.7% in fiscal year 2013

The rule also outlines parameters around the Hospital Readmissions Reduction Program, set to begin October 1, under which hospitals with higher-than-expected readmission rates will see reductions in their Medicare payments. For the first year of the program, CMS will use three existing 30-day readmission measures for heart attack, heart failure and pneumonia patients.

In addition, the rule strengthens the Hospital Value-Based Purchasing Program. This includes adding a new outcome measure, central line-associated bloodstream infection, to the program.

The long-term care hospital (LTCH) increase includes a 2.6% market-basket update, which is offset by two payment reductions under the Affordable Care Act (ACA) and, for patients discharged on or after December 29, a payment cut for very short-stay outlier cases. The final rule also delays full implementation of the “25% Rule” for one year for cost reports beginning between October 1, 2012 and October 1, 2013. The rule also implements a proposed one-time, permanent reduction of 3.75%. The payment cut will be phased in over three years, beginning with a 1.266% cut for discharges occurring on and after December 29, 2012.

The final rule will appear in the August 31, 2012 Federal Register, and will take effect on October 1, 2012.

The final rule is available at http://www.ofr.gov/OFRUpload/OFRData/2012-19079_PI.pdf