CMS’ 2019 OPPS proposed rule continues the agency’s efforts to enforce site-neutral payments and reduce drug payments.
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News

2019 OPPS proposed rule: CMS continues push for site-neutral reimbursement and lower drug payments
Source: Revenue Cycle Advisor
CMS’ 2019 OPPS proposed rule continues the agency’s efforts to enforce site-neutral payments and reduce drug payments by introducing policies to reduce reimbursement for hospital outpatient clinic visits at off-campus, provider-based departments (PBD) and expanding last year’s payment reductions for drugs purchased under the 340B discount pricing program by nonexcepted PBDs.
FY 2019 IPPS proposed rule: Tackling proposed changes to MDCs
Source: JustCoding
Adriane Martin, DO, FACOS, CCDS, summarizes the proposed changes found in the fiscal year (FY) 2019 IPPS proposed rule, broken down by Major Diagnostic Category (MDC), that would impact ICD-10-CM/PCS codes.
ACA risk-adjustment payments unfrozen
Source: HealthLeaders Media
Two and a half weeks of heightened uncertainty for insurers came to a close Tuesday evening, when CMS announced a final rule to resume risk-adjustment payments under the Affordable Care Act for the 2017 benefit year.
 

Revenue Cycle Advisor Subscriber Content

Note from the instructor: Managing infusions, a nemesis of revenue integrity
Source: Revenue Cycle Advisor
This week's note from the instructor reviews ways to stay compliant when billing for infusions and what role the revenue cycle leadership can play in overseeing the billing process for these services.
 

Daily Q&A

Q&A: Reviewing employee patient history during routine vaccine
Source: Revenue Cycle Advisor
Q: If an employee of our facility is seen for a routine vaccine, is it permissible for the nurse to review the patient history?

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Upcoming CMS Events

Tuesday, 8/14 - ESRD Quality Incentive Program: CY 2019 ESRD PPS Proposed Rule Call
Monday, 8/20 - Advisory Panel on Hospital Outpatient Payment Meeting, Day 1
Tuesday, 8/21 - Advisory Panel on Hospital Outpatient Payment Meeting, Day 2
Wednesday, 8/22 - MEDCAC - Chimeric Antigen Receptor (CAR) T-Cell Therapy and Patient Reported Outcomes
 

Product Spotlight

Longitudinal Case Management: Designs Across the Continuum of Care

Case management has grown beyond the walls of inpatient care sites; it now also supports and manages care in ambulatory settings. This book provides guidance on establishing case management processes to bridge the gap between care settings such as ambulatory, acute, and postacute with the goal of arming the patient with community resources to thrive.
 

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What's New

CMS Sepsis Reporting Is Going Public, Are You Ready?

Learn about the CMS timetable for public reporting of sepsis performance measures and how to prepare your facility.
 
 

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