On November 1, CMS issued a final rule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) effective on or after January 1, 2020. Payment Provisions: Ratesetting and conversion factor CMS is finalizing a series of standard technical proposals involving practice expense, including […]
FY 2020 Information IRF-PAI (version 4.0 FINAL) – Effective October 1, 2020 (FY 2021), as proposed in the FY 2020 IRF PPS final rule. Change Table listing differences from the previous version IRF-PAI Manual Version 3.0 – This manual contains information regarding data collection on the IRF-PAI version 3.0, effective October 1, 2019. Please note that the IRF-PAI Manual […]
FY 2018 IRF PPS Final Rule Data Files (82 FR 36238) IRF Rate Setting Final Rule (82 FR 36238) This file contains data for each of the 1,140 inpatient rehabilitation facilities used to estimate the policy updates in the final inpatient rehabilitation prospective payment system regulation. The methodology used to update the payment data is described […]
On October 1, 2015, the ICD-9 code sets used to report medical diagnoses and inpatient procedures were replaced by ICD-10 code sets. The transition to ICD-10 is required for everyone covered by the Health Insurance Portability Accountability Act (HIPAA). Please note, the change to ICD-10 does not affect CPT coding for outpatient procedures and physician services. Click […]
As part of CMS’s annual changes to the Medicare Physician Fee Schedule and Quality Payment Program, the agency’s proposals are aimed at reducing burden, recognizing clinicians for the time they spend with patients, removing unnecessary measures and making it easier for them to be on the path towards value-based care. Last year, the Trump Administration finalized […]
On July 29, CMS issued a proposed rule that proposes to update payment policies and rates under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to beneficiaries on or after January 1, 2020. This rule also: Proposes updates to the Acute Kidney Injury (AKI) dialysis payment rate for renal dialysis […]
CMS is proposing price transparency requirements that will increase competition among all hospitals by requiring them to make pricing information publicly available. As a result, patients would be able to shop for health care that meets their needs and budgets. The proposals for calendar year (CY) 2020 includes historic changes that would require hospitals to […]
New OCR Guidance for Health Care Providers and Consumers on the HIPAA Privacy Rule and Communications with a Patient’s Family, Friends, or Others Involved in the Patient’s Care The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) has provided two websites containing HIPAA Privacy Rule guidance documents – one for health […]
Section 6409 of the Patient Protection and Affordable Care Act (ACA) was signed into law on March 23, 2010. Section 6409(a) of the ACA required the Secretary of the Department of Health and Human Services, in cooperation with the Inspector General of the Department of Health and Human Services, to establish a Medicare self-referral disclosure […]