July, 2011 - Make Your Revenue Smarter

CMS Implements Payment, Policy Changes For Inpatient Rehabilitation Facilities

On , in Industry News, by AQ-IQ LLC

From the HHS Press Release: Final rule adopts measures for new IRF Quality Reporting Program CMS issued a final rule Friday that updates Medicare payment policies and rates for more than 1,200 freestanding and hospital-based inpatient rehabilitation facilities (IRFs) in Fiscal Year (FY) 2012. The final rule increases IRF payment rates under the IRF Prospective […]

More Accurate FY 2012 Payments For Medicare Skilled Nursing Facilities

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From the HHS Press Release: Case-Mix Indexes Recalibrated CMS announced a final rule reducing Medicare skilled nursing facility (SNF) Prospective Payment System (PPS) payments in FY 2012 by $3.87 billion, or 11.1 percent lower than payments for FY 2011. The FY 2012 rates correct for an unintended spike in payment levels and better align Medicare […]

Final Wage Index Changes For Medicare Hospices Increase FY 2012 Payments By 2.5%

On , in Industry News, by AQ-IQ LLC

From the HHS Press Release: Case-Mix Indexes Recalibrated Hospices serving people with Medicare will see a 2.5 percent increase in their Medicare payments for fiscal year (FY) 2012, according to a final regulation released  by CMS.   Hospices are also called upon to begin reporting on the quality of care received by Medicare patients, as a […]

RAC Program Results (June, 2011)

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Medicare Fee-for-Service Recovery Audit Program as of June 17, 2011 CMS has prepared an overview of the combined results of the RAC program to date. This document also highlights the top issue for each contractor.   Click here to download the document.  

Private Nonprofit Health Plans To Increase Competition & Choice

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From the HHS Press Release: CMS took steps to encourage the creation of Consumer Operated and Oriented Plans (CO-OPs), new private non-profit, consumer-governed health insurance plans that will help increase competition and give consumers and small businesses additional affordable health insurance choices.   CMS is proposing standards for CO-OPs, and for qualifying for $3.8 billion in […]

Private Nonprofit Health Plans To Increase Competition & Choice

From the HHS Press Release: CMS took steps to encourage the creation of Consumer Operated and Oriented Plans (CO-OPs), new private non-profit, consumer-governed health insurance plans that will help increase competition and give consumers and small businesses additional affordable health insurance choices.   CMS is proposing standards for CO-OPs, and for qualifying for $3.8 billion in […]

HHS and states move to establish Affordable Insurance Exchanges, give Americans the same insurance choices as members of Congress

On , in Industry News, by AQ-IQ LLC

From the HHS Press Release:   Proposed Rules Offer States Flexibility, Choices, Competition And Clout For Consumers And Small Businesses On July 11, the U.S. Department of Health and Human Services (HHS) proposed a framework to assist states in building Affordable Insurance Exchanges, state-based competitive marketplaces where individuals and small businesses will be able to […]

HHS and states move to establish Affordable Insurance Exchanges, give Americans the same insurance choices as members of Congress

From the HHS Press Release:   Proposed Rules Offer States Flexibility, Choices, Competition And Clout For Consumers And Small Businesses On July 11, the U.S. Department of Health and Human Services (HHS) proposed a framework to assist states in building Affordable Insurance Exchanges, state-based competitive marketplaces where individuals and small businesses will be able to […]

Guidance on Hospital Inpatient Admission Decisions

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This document is from: MLN Matters Article #:SE1037 Guidance on Hospital Inpatient Admission Decisions It is important that any staff involved with the clinical decision to admit the patientstay abreast of all CMS national inpatient hospital policy and National and Local Coverage Determinations. Additionally, make sure medical documentation submitted demonstrates evidence of the clinical need […]