1.800.456.4350 info@prgweb.com

Archive for November, 2015

Joint Commission Issues Annual Report

Tuesday, November 17th, 2015

On November 17, The Joint Commission announced the release of America’s Hospitals: Improving Quality and Safety: The Joint Commission’s Annual Report 2015, summarizing data on 49 accountability measures reported by more than 3,300 Joint Commission-accredited hospitals in 2014.  The 2014 data shows how well hospitals are performing on evidence-based care processes for the treatment of conditions such as heart attack, pneumonia, and stroke. The report also includes the recognition of 1,043 hospitals that are performing exceptionally well on these patient care processes, earning them special recognition as a Top Performer on Key Quality Measures® based on 2014 data.

The press release can be found by visiting http://jointcommission.new-media-release.com/2015_annual_report_release/

CMS Announces Medicare CY 2016 Premiums and Deductibles

Tuesday, November 10th, 2015

On November 10, the Centers for Medicare & Medicaid Services (CMS) announced that the Medicare Part A deductible for inpatient hospital services will increase by $28 in calendar year 2016, to $1,288. The Part A daily coinsurance amounts will be $322 for days 61-90 of hospitalization in a benefit period; $644 for lifetime reserve days; and $161 for days 21-100 of extended care services in a skilled nursing facility in a benefit period. The monthly Part A premium will increase by $4 in CY 2016, to $411. For Medicare Part B, most of the Medicare beneficiaries with will not experience an increase in their monthly premium in CY 2016 because there was no increase in their Social Security cost-of-living adjustment (COLA). However, for approximately 30% of beneficiaries, the standard Part B premium will increase to $121.80.

The fact sheet is available at https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2015-Press-releases-items/2015-11-10.html

RAC Program Improvements Announced

Monday, November 9th, 2015

Effective January 1, the Centers for Medicare & Medicaid Services (CMS) will reduce the number of claims that Recovery Audit Contractors (RAC) may audit for health care providers other than physicians and suppliers. The additional documentation request (ADR) limit will fall from 2% to 0.5% of the provider’s total number of paid Medicare claims from the previous year. RACs will be required to diversify their audits across all claim types for a facility, limiting their ability to target care provided in a particular setting. In addition, CMS will adjust the ADR limit up or down based on the provider’s claim denial rate.

For further details, visit https://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/Recovery-Audit-Program/Downloads/Additional-Documentation-Request-Limits-.pdf