CMS recently released an MLN article targeting hospitals and billing for patient care that involves a home health admission. When patients are transferred, a hospital is typically paid at per diem rate. An OIG report last year found improper payments tied to hospital claims that should have been subject to the transfer policy because the […]
The Biden administration has named Liz Richter the acting administrator for CMS. Richter has served since 1990 and most recently served as deputy director of the Center for Medicare, according to CMS. Richter began in the Bureau of Policy Development working on inpatient hospital payment policy. She later worked on a variety of Medicare payment […]
The Department of Health and Human Services (HHS) recently began releasing new hospital COVID-19 data at the facility level. The data shows weekly impacts from COVID-19 on ICU and bed capacity. When announcing the new datasets last month, HHS noted that it should help local and regional collaborations. Home health industry leaders have noted that […]
Self-reported quality metrics from SNFs don’t align with hospital diagnoses for some quality measures, a new report shows. Most noticeably, pressure ulcers were vastly underreported by more than half of SNFs, according to the report from Integra Med Analytics. “The median ratio of the self-reported and hospital-based pressure ulcer rates was 0.48, indicating that over […]
Coders will have new ICD-10-CM codes to report pressure-induced deep tissue damage, acute versus chronic embolism and thrombosis and fractures of the facial bones around the eye, among other changes. All told, 273 codes are proposed to be added, 30 codes revised and 21 invalidated in the ICD-10-CM code set for fiscal year 2020. The […]
On April 16, 2015, the Centers for Medicare & Medicaid Services (CMS) introduced star ratings on Hospital Compare, the agency’s public information website, to make it easier for consumers to choose a hospital and understand the quality of care they deliver. This announcement builds on a larger effort across HHS to build a health care […]
Q: What is the minimum minutes of evaluation on a Part A patient that needs rehab? A: There isn’t any minimum minutes indicated in the MDS. Therapy evaluations are performed by licensed therapists who are guided by their practice standards and also must meet Medicare criteria for skilled rehabilitation.
Regulatory Specialist Diane Brown answers whether a resident qualifies for another 100 Medicare benefit days after exhausting the first 100 benefit days.