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Payment Matters
May 13, 2011
Quality & Efficiency: Key Themes in the Fiscal Year (FY) 2012 IPPS Proposed Rule
By: Sarah E. Swank and Kristin Cilento Carter
The Centers for Medicare and Medicaid Services (CMS) continued its focus to seek high quality care and reduction of costs with the fiscal year (FY) 2012 inpatient prospective payment system (IPPS) proposed rule. Below is a summary of some of the key quality proposals in the IPPS proposed rule, including (1) the Hospital Inpatient Quality Reporting (IQR) program; (2) the Hospital Value Based Purchasing (VBP) program; (3) the Hospital Readmissions Reduction Program and (4) the Hospital Acquired Conditions payment limitation.
Click to continue...FFY 2012 IPPS Proposed Rule Would Eliminate Hospice Data from the IME and DSH Calculations, and Would Modify the ESRD Add-On Payment Calculation
By: Leslie Demaree Goldsmith and Mark A. Stanley
Under the Inpatient Prospective Payment System (IPPS) Proposed Rule for federal fiscal year (FFY) 2012, hospitals that serve a disproportionate share of Medicaid or end-stage renal disease (ESRD) patients would see changes to their payment adjustments. Hospitals that treat a large number of hospice patients on an inpatient basis will be particularly interested in proposed changes to the indirect medical education (IME) and disproportionate share hospital (DSH) adjustments. Hospitals that qualify for the add-on payment for hospitals with at least 10% ESRD discharges would also be affected by the proposed rule.
Click to continue...Stay Tuned for Changes to CMS 855 Enrollment Forms
By: Donna J. Senft
CMS recently published revised drafts of the current Medicare enrollment forms (i.e., the CMS 855A, CMS 855B, CMS 855I, CMS 855R and CMS 855S). In addition, CMS is proposing a new CMS 855O form, which would allow a physician who otherwise does not need to have Medicare billing privileges, to submit an application for the sole purpose of complying with the requirement that a physician must have a Medicare identification number to provide orders or referrals for certain Medicare-covered items and services.
Click to continue...New Information Technology Grant Funding Opportunity for Existing Rural Health Networks
If your organization is a member of a formally organized Rural Health Network (RHN), a new grant program promises up to $300,000 per year for the next three years to support your adoption and meaningful use of electronic health record (EHR) technology. On April 27, 2011, the Health Resources and Services Administration issued notice that it would be accepting applications from existing RHNs for the 3 year grants to “provide targeted HIT support to existing health care networks in Rural America where the need is most critical.” Up to 40 grants will be awarded.
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