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*  Indiana General Assembly - Indiana Register
This rule amendment is also necessary to ensure payment is not made for other provider-preventable conditions. On June 6, 2011 ... critical access hospitals and hospitals that are not reimbursed under the DRG prospective payment system, such as psychiatric ... Under this rule amendment, the hospital-acquired conditions policy will now apply to all inpatient hospital services. ... Certain hospitals that were not previously required to report the present-on-admission (POA) indicator on inpatient claims will ...
  http://www.in.gov/legislative/iac/20131009-IR-405130422EIA.xml.html
*  Hospital-acquired condition - Wikipedia
On July 31, 2008, in the inpatient prospective payment system (IPPS) fiscal year (FY) 2009 Final Rule, the Centers for Medicare ... Medicaid Services (CMS) selected 10 categories of conditions for a HAC payment provision. For discharges occurring on or after ... hospitals no longer receive additional payment for cases in which one of the selected conditions was not present on admission. ... Conditions selected for implementation These conditions will have payment implications beginning in October 1, 2008. Object ...
  https://en.wikipedia.org/wiki/Hospital-acquired_condition
*  Medicare Boot CampĀ®-Utilization Review Version
Inpatient Prospective Payment System (IPPS). *Three-day payment window and pre-admission services ... Comprehensive APCs (i.e., outpatient surgical encounter based payments). *Inpatient Part B payment and billing with condition ... Explain CMS' 2-midnight rule benchmark *Recognize exceptions to the 2-midnight benchmark ... Module 6: Part B Payment for Inpatient and Outpatient Services. *Basics of the Outpatient Prospective Payment System (OPPS), ...
  http://hcmarketplace.com/medicare-boot-camp-ut-reviewvrsn
*  Untitled Document
In 2008, the Centers for Medicare & Medicaid Services published the final rule for their Inpatient Prospective Payment System ( ... "hospitals will not receive additional payment for cases in which one of the selected conditions was not present on admission. ... Such charges and/or days shall be removed from the claim prior to submitting to the Health Plan for payment. Current and valid ... In the FY 2016 HAC Reduction Program, hospitals with a Total HAC Score greater than 6.75 are subject to a payment reduction of ...
  http://www.rnceus.com/fall3/Background_16.html
*  PT in Motion News
... has released its proposed rule for the Home Health Prospective Payment System (HH PPS) for 2015. The rule proposes a home ... CMS clarifies that admission orders are a condition of payment for all inpatient hospital admissions. However, CMS will require ... The rule proposed July 3 by the Centers for Medicare and Medicaid Services (CMS) includes a 2.1% increase in payment rates for ... An APTA summary of the Medicare proposed rule for the 2015 home health prospective payment system guides members through the ...
  http://www.apta.org/PTinMotion/NewsNow/?blogmonth=7&blogyear=2014&blogid=10737418615
*  GAO-08-673T, Health-Care-Associated Infections in Hospitals: Leadership Needed from HHS to Prioritize Prevention Practices and...
CMS plans to propose additional conditions in the fiscal year 2009 Hospital Inpatient Prospective Payment Systems proposed rule ... Medicaid Services: COP: condition of participation: DRA: Deficit Reduction Act of 2005: DRG: diagnosis-related group: FDA: Food ... the diagnoses that were present in patients at the time of admission in order for CMS to determine if a preventable condition ... Additional preventable conditions that will no longer result in higher payments to hospitals include hospital- acquired ...
  https://www.gao.gov/htext/d08673t.html
*  The FY 2015 Inpatient Prospective Payment System final rule | The Bulletin
... which withholds payments to hospitals for select conditions not present upon admission to the hospital. ... On August 4, the Centers for Medicare & Medicaid Services (CMS) released the Inpatient Prospective Payment System (IPPS) final ... The FY 2015 Inpatient Prospective Payment System final rule. The FY 2015 Inpatient Prospective Payment System final rule. By ... The 2017 Inpatient Prospective Payment System: What it means for surgery. *The 2018 Inpatient Prospective Payment System final ...
  http://bulletin.facs.org/2014/11/the-fy-2015-inpatient-prospective-payment-system-final-rule/
*  June 12, 2007 - ASM Submits Comments on CMS Proposed Rule Regarding Hospital Acquired Infections
Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2008 Rates; Proposed Rule ... In other words, colonization with S. aureus may actually represent a condition "POA" (present on admission) that is a risk ... Centers for Medicare & Medicaid Services. Department of Health and Human Services. Attn: CMS-1533-P. P.O. Box 8011. Baltimore, ... Therefore, ASM members have a significant interest in ensuring that any revisions to the Inpatient Prospective Payment System ...
  https://www.asm.org/index.php/documents/statements-and-testimony/97-policy/documents/2162-june-12-2007-asm-submits-comments-on-cms-proposed-rule-regarding-hospital-acquired-infections
*  U.S. GAO - Medicare Home Health Payment: Nonroutine Medical Supply Data Needed to Assess Payment Adjustments
The Home Health Prospective Payment System (PPS) final rule, published August 29, 2007 (72 FR 49762) established new payment ... Agency Affected: Department of Health and Human Services: Centers for Medicare and Medicaid Services ... namely those that a patient had been using prior to home health care to treat an ongoing condition. Clinical experts indicated ... is of particular concern for patients who have nonroutine medical supply needs that are easily identified prior to admission or ...
  https://www.gao.gov/products/GAO-03-878
*  Medicare's Big Changes | Managed Care magazine
... was adopted in 1983 as a prospective system. Payments to hospitals were made based on admission diagnosis. But that system was ... "The rule continues the transformation of the Medicare program to a prudent purchaser of services by proposing a number of ... Moving to a payment system tied to the severity of illness and refusing to pay for hospital-acquired conditions may encourage ... Reform to address this flaw in the prospective system of payment began with the Deficit Reduction Act of 2005, which was a ...
  http://managedcaremag.com/archives/2008/5/medicare%E2%80%99s-big-changes?page=358
*  REHAB RULES REVISITED - PDF
... particularly the implementation of the new prospective payment ... Prospective Payment System Payment Rule Brief FINAL RULE ... Inpatient Rehabilitation Facility Prospective Payment System for. AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ... Site-neutral payments for select conditions treated in inpatient rehabilitation facilities and skilled nursing facilities C h a ... 2013 FAQ Categories Inpatient Admission Criteria 2 Midnight Rule... 3 Medical Review Criteria... ...
  http://docplayer.net/1403039-Rehab-rules-revisited.html
*  Delays, Controversy Muddle CMS' Two-Midnight Rule for Hospital Patient Admissions | The Hospitalist
And, for the fourth time since the two-midnight rule was introduced in the 2014 Hospital Inpatient Prospective Payment System, ... A new rule issued by the Centers for Medicare & Medicaid Services (CMS) is at the center of controversy fueled by competing ... Hospitals and providers have until March 31, 2015, before auditors begin scrutinizing patient admission statuses for ... "It should be a decision a physician reaches based on a patient's condition." ...
  https://www.the-hospitalist.org/hospitalist/article/126277/health-policy/delays-controversy-muddle-cms-two-midnight-rule-hospital
*  CMS Announces Payment Changes for Medicare Home Health Agencies for 2018 | CMS
Medicaid Services (CMS) issued a final rule (CMS-1672-F) that updates the calendar year (CY) 2018 Medicare payment rates and ... payment rate to account for nominal case-mix growth results in an estimated decrease in Home Health Prospective Payment System ... Application of Percent of Long-Term Care Hospital Patients with an Admission and Discharge Functional Assessment and a Care ... will also satisfy the requirement to report standardized patient assessment data on medical conditions and comorbidities, and ...
  https://www.cms.gov/newsroom/fact-sheets/cms-announces-payment-changes-medicare-home-health-agencies-2018
*  Healthcare Case Management - Discharge Planning, Medicare Compliance, and Observation Status - Billing and Reimbursement - www...
"Acute Care Hospital Inpatient Prospective Payment System" is now available in print... ... Mentor moment: CMS says providers cannot use condition code 44 to backdate observation services * Case Management Weekly, Issue ... In a recent HCPro audio conference titled " Observation Services v. Inpatient Admission... ... News: CMS releases ACO proposed rule, seeks comments * Case Management Weekly, Issue 15, April 13, 2011 The April 7 issue of ...
  http://www.hcpro.com/archive-topic-CT_REM_006-department-case-management.html
*  Health Care Law Attorneys | Bricker & Eckler
On April 30, 2014, the Centers for Medicare & Medicaid Services (CMS) issued the inpatient prospective payment system (IPPS) ... the FY 2015 IPPS rule proposes to amend the regulations to eliminate the provider dissatisfaction requirement as a condition ... Percent of Long-Term Care Hospital Patients with an Admission and Discharge Functional Assessment and a Care Plan That ... CMS issues proposed payment rules for inpatient hospital and long-term care hospital prospective payment system for 2015 fiscal ...
  https://www.bricker.com/industries-practices/health-care/insights-resources/publications/cms-issues-proposed-payment-rules-for-inpatient-hospital-and-long-term-care-hospital-prospective-payment-system-for-2015-fiscal-year
*  CMS Issues Notice of Proposed Rulemaking for New Bundled Payment Models - Lexology
... covering services provided to Medicare beneficiaries admitted to certain Inpatient Prospective Payment System ('IPPS') ... Under the Proposed Rule, CMS would create EPMs for care episodes related to the following conditions:. *Acute Myocardial ... Episode Initiation and Payment Under EPMs. Under the proposed EPMs, an episode would begin with an inpatient admission to an ... Cardiac Rehabilitation Incentive Payment Model. The Proposed Rule introduces the Cardiac Rehabilitation Incentive Payment Model ...
  https://www.lexology.com/library/detail.aspx?g=b765ef7a-4615-416f-a4e0-fa5b65a62088
*  FY 2016 Final Rule: Highlights for Inpatient Rehabilitation Facilities - RACmonitor
Prospective Payment System for Federal Fiscal Year 2016 recently released has no real surprises. The Fina... ... Requirement to Record Modes and Minutes of Therapy Services. *Completion of the Attestation Statement for Certain Arthritis ... for Presumptive Eligibility of the CMS-13 requirements and for qualification of Tier Level payment for comorbid conditions are ... An application of Percent of LTCH Patients with an Admission and Discharge Functional Assessment and a Care Plan that Addressed ...
  https://www.racmonitor.com/fy-2016-final-rule-highlights-for-inpatient-rehabilitation-facilities
*  VM -- Assisted, May 08 ... Virtual Mentor
... treatment for eight hospital-acquired conditions will no longer be reimbursed by Medicare. Virtual Mentor is a monthly ... RE: Medicare inpatient prospective payment system (IPPS) proposed rule [memo]. Chicago, IL: American Medical Association; June ... To facilitate the identification of pre-existing conditions, CMS has developed a "present-on-admission" indicator code that ... The CMS has employed the services of the non-profit think tank RAND Corporation in several projects, including the revamping of ...
  http://virtualmentor.ama-assn.org/2008/05/pfor1-0805.html
*  ANA Advises Federal Agencies
... the payment policies and the annual payment rates for the Medicare prospective payment system for inpatient hospital services ... HHS published a proposed rule entitled Conditions of Participation for Home Health Agencies; Proposed Rule. The proposed rule ... ANA also supports the proposed public reporting of a measure on the length of time between emergency department admission and ... Prospective Payment System (PPS), which updated and revised the case-mix adjusted bundled prospective payment system for renal ...
  http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Federal/AGENCIES/ANA-Advises-Federal-Agencies
*  A classification of hospital-acquired diagnoses for use with routine hospital data | The Medical Journal of Australia
... changes to the hospital inpatient prospective payment system and fiscal year 2008 rates; final rule. Washington, DC: Office of ... conditions present on admission) and complications (hospital-acquired diagnoses). Thus, it could not include conditions such as ... Assignment of the condition-onset flag has not been audited, although the annual Victorian Department of Human Services ... The complications flag (C prefix20) used in Victoria was the model for the recently adopted national system of "condition onset ...
  https://www.mja.com.au/journal/2009/191/10/classification-hospital-acquired-diagnoses-use-routine-hospital-data
*  Developing Successful Hospital Partnerships - PDF
MHA Director of Operations Services Publication Date: May Sawgrass Partners, LLC DEVELOPING SUCCESSFUL HOSPITAL PARTNERSHIPS ... Payment Rule Summary Medicare Payment Inpatient Prospective System Federal Fiscal Year 2012 Final Rule. South Carolina Hospital ... EFFECT OF THE HOME HEALTH PROSPECTIVE PAYMENT SYSTEM Department of Health and Human Services OFFICE OF INSPECTOR GENERAL EFFECT ... More and more adult child and hospital discharge planners are basing admission decisions on a community s CMS 5-star rating, ...
  http://docplayer.net/10462019-Developing-successful-hospital-partnerships.html
*  CMS rule-a-palooza finalizes a host ofMmedicare payment updates - Lexology
... policies and rates for fiscal year 2012 for acute care hospitals under the inpatient hospital prospective payment system, long- ... Medicaid Services recently released some 2,000 pages of final rules updating Medicare payment ... Under the final rule, routine services such as room and board, nursing services and ICU services may be provided under ... Hospital-Acquired Conditions. CMS decided not to follow its proposal to add a new hospital-acquired condition (HAC) in FY 2012 ...
  https://www.lexology.com/library/detail.aspx?g=ad85dac4-74e4-4313-a6eb-0371735813d5
*  GAO-11-130R, Long-Term Care Hospitals: Differences in Their Oversight Compared to Other Types of Hospitals and Nursing Homes
... and limited rehabilitation services. * Medicare pays for ACH services using the inpatient prospective payment system (IPPS). ... short-term care for a broad range of medical conditions and provide diagnostic or therapeutic services, surgery, ... Estimated release for public comment is in May 2011, with the final rule expected to be issued in May 2012. * TJC officials ... CMS officials told us that the changes to the COPs may reflect the patient admission and discharge process, staffing ...
  https://www.gao.gov/assets/100/97202.html
*  Ten Things about Oct. 1 that Coders and CDI Specialists Need to Know Now! - ICD10monitor
... final rule brings with it a number of changes that are likely to have an even bigger impact on do... ... The 2017 Inpatient Prospective Payment System (IPPS) final rule brings with it a number of changes that are likely to have an ... I do not yet have the present-on-admission (POA) guidelines, but I would not be surprised if the later stage, which is reported ... We have Centers for Medicare & Medicaid Services (CMS) rules that have been in place for nearly 30 years, in some cases, being ...
  https://www.icd10monitor.com/ten-things-about-oct-1-that-coders-and-cdi-specialists-need-to-know-now
*  American Heart Association's Call to Action for Payment and Delivery System Reform | Circulation
Centers for Medicare & Medicaid Services (CMS), HHS. Medicare Program: Merit-based Incentive Payment System (MIPS) and ... Similar to the Hospital Inpatient Prospective Payment System, which reimburses hospitals for inpatient care based on patients' ... A new MSSP track 1+, which is yet to be developed but was mentioned in the recent final rule for the Quality Payment Program, ... Track 3 ACOs are also subject to a waiver of the requirement that a patient have a 3-night hospital stay before admission to a ...
  http://circ.ahajournals.org/content/136/7/e162