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Archive for October, 2012

CDC Publishes Report on CHF Hospitalizations

Wednesday, October 17th, 2012

According to a new report from the Centers for Disease Control and Prevention (CDC), the overall hospitalization rate for congestive heart failure (CHF) was unchanged between 2000 and 2010, but increased 21% for men under age 65 and declined significantly for older women. The report states that because men have higher health risk factors and lower utilization of health care services, this could mean that conditions known to cause CHF, such as diabetes, hypertension and coronary artery disease, are more often left undiagnosed and untreated for men as compared to women.

The report can be viewed at http://www.cdc.gov/nchs/data/databriefs/db108.htm.

Technical Correction Issued to Final Rule for LTCHs

Monday, October 15th, 2012

The Centers for Medicare & Medicaid Services (CMS) has issued a technical correction to the final rule for long-term care hospitals (LTCHs) for fiscal year 2013. The notice, which became effective on October 1, specifies CMS’ methodology for determining the percentage of discharges that will not count toward the 25% payment adjustment threshold policy for LTCHs and their satellite facilities with cost reporting periods beginning between July 1 and October 1, 2012. CMS said the document corrects technical and typographical errors in the text of the FY 2013 Inpatient Prospective Payment System/LTCH PPS final rule published August 31. However, there will not be substantive changes to the policies or payment methodologies that were adopted in the final rule.

The notice can be found by going to http://www.ofr.gov/OFRUpload/OFRData/2012-25464_PI.pdf

MedPAC Discusses Recommendations for Outpatient Therapy Payment

Saturday, October 6th, 2012

The Medicare Payment Advisory Commission (MedPAC) discussed draft recommendations for reforming the Medicare benefit for outpatient physical and occupational therapy and speech-language pathology to control spending while improving care and access to services. Their recommendations include reducing the annual spending limits for beneficiaries while maintaining a manual exceptions process to accommodate additional therapy needs; including hospital outpatient services in the spending caps; and prohibiting therapy (v-codes) as the primary diagnosis when billing for outpatient therapies. MedPAC also discussed the recommendation for a standardized tool to classify patients by severity, assess the impact of therapies received, and set the stage for future payment bundling. Program integrity recommendations include reducing the treatment plan certification period to 45 days from 90 days; targeting high-use areas and aberrant providers; imposing a moratorium on new providers and requiring current providers to re-enroll in the program. The Commission must report its final recommendations to Congress by June 15, 2013.

The recommendations can be accessed at http://www.medpac.gov/.

OIG Issues 2013 Work Plan

Wednesday, October 3rd, 2012

The Department of Health and Human Services’ (DHHS) Office of Inspector General (OIG) has published its work plan for fiscal year 2013. The plan summarizes the new and ongoing reviews and activities that OIG plans to pursue with respect to HHS programs and operations during the next fiscal year and beyond. For hospitals, new items include a review of how hospital billing for inpatient stays changed from FY 2008 to FY 2012, and a review of Medicare payments made to hospitals for beneficiary discharges that should have been coded as transfers.

The work plan can be found at https://oig.hhs.gov/reports-and-publications/workplan/index.asp#current