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As 2016 comes to a close, ACMA would like to wish its members, partners and other industry professionals a safe and happy holiday season. As we reflect on the past year for the industry, we would like to provide the readers of the briefCASE a look at the most accessed articles from the year. Our regular publication will resume Wednesday, Jan. 4.
1. Medicare Releases Draft Proposal For Patient Observation Notice
Kaiser Health News
From June 22: In just two months, a federal law kicks in requiring hospitals to tell their Medicare patients if they have not been formally admitted and why. But some physician, hospital and consumer representatives say a notice drafted by Medicare for hospitals to use may not do the job.
The law was a response to complaints from Medicare patients who were surprised to learn that although they had spent a few days in the hospital, they were there for observation and were not admitted.
2. Medicare denies post-hospital care costs for patients 'under observation'
NBC New York
From Jan. 27: A Connecticut man was charged with a $7,700 bill for the weeks he spent in a rehabilitation center unknowingly "under observation," a patient status that is not covered by Medicare.
"Well I'm glad I'm still around," said the victim, Angelo Verdini, a North Haven resident who will turn 90 in March.
After several appeals, he says he fears he will have to fight Medicare until his death.
3. Observation Stay Notices Will Cost Hospitals $23 Million Every Year
From Aug. 17: A new requirement for hospitals to notify Medicare patients when they are receiving observation care but have not been admitted will cost the industry $23 million every year, according to the CMS.
The agency estimates that 1.4 million beneficiaries will receive annual notices.
The Notice of Observation Treatment and Implication for Care Eligibility Act requires hospitals to notify beneficiaries receiving observation services for more than 24 hours.
4. More than 50 hospitals sue CMS over two-midnight rule cuts
From Jan. 13: Fifty-five hospitals have filed a lawsuit against the Department of Health and Human Services in response to Medicare payment reductions under the "two-midnight" rule.
FierceHealthFinance obtained a copy of the lawsuit from Foley & Larder LLP, a lawfirm based in the District of Columbia that is representing the 55 hospitals.
Under the controversial rule, the Centers for Medicare & Medicaid Services treats any hospital stay lasting less than two midnights as an outpatient stay.
- Full Service Medical Repatriation And Placement- Latin America, Caribbean, Asia, Africa, Middle East, Eastern Europe
- Global Placement Services: Hospitals, Nursing Homes, Assisted Livings, Dialysis Services
- Expedited Family Locator, Immigration Services, Identification/Travel Documents
- 99% Of Acute & Sub-Acute Patient Transported Via Air Ambulance Or Commercial Flights With Medical Escort
- Reduce Risk And Length Of Stay
5. CMS Delays Implementation of NOTICE Act in Final Rule
From Aug. 10: On Aug. 2, 2016, the Centers for Medicare & Medicaid Services released its Hospital Inpatient Prospective Payment System and Long-Term Acute Care Hospital Final Rule Issues for Fiscal Year 2017, which are set to be published on Aug. 22, 2016, and effective Oct. 1, 2016. CMS included the final rule for Hospital Notification Procedures Applicable to Beneficiaries Receiving Observation Services to implement the Notice of Observation Treatment and Implication for Care Eligibility Act.
6. Hospitals Brace For New Medicare Payment Rules
Wall Street Journal
From April 6: Starting soon, sweeping changes in Medicare payments could affect nearly 800 U.S. hospitals' bottom lines, but not everyone is ready for the switch.
The new rules will hold hospitals accountable for all the costs of hip and knee replacements for 90 days. If patients recover and go home quickly, hospitals could reap savings. If patients have complications or need lengthy stays in a rehab facility, hospitals could owe Medicare instead.
7. ACMA raises concerns, shares recommendations with CMS on proposed rule
From Jan. 6: On Dec. 30, ACMA submitted a letter to CMS Administrator, Andrew Slavitt, detailing concerns and requests related to the agency's proposed rule to revise the discharge planning requirements that hospitals — including long-term care hospitals and inpatient rehabilitation facilities, critical access hospitals, and home health agencies — must meet in order to participate in the Medicare and Medicaid programs.
The letter includes concerns and recommendations submitted by ACMA members, as well as ACMA's Public Policy Committee and the ACMA National Board of Directors.
8. Studies Pinpoint Likelihood of 30-Day Readmissions, Identify Prevention Measures
From March 9: Hospitals could have prevented more than a quarter of readmissions of discharged Medicare patients within 30 days, according to a study published in JAMA Internal Medicine by researchers at the University of California San Francisco.
The study at 12 academic medical centers across the country found that 15 percent of readmissions were almost certainly preventable, and 12 percent were more likely than not preventable.
9. Are Hospital Readmission Rates Reliable Care Quality Measures?
From March 2: New federal research that shows that contrary to earlier concerns, hospitals don't hike observation status to create the illusion of a drop in readmissions, has called into question whether readmissions are a reliable care quality measure.
Ashish Jha, M.D., an associate professor of Health Policy and Management at the Harvard School of Public Health, in a post for The Health Care Blog, called the latest findings good news. But he said that readmission rates are a measure of utilization, not an outcome in and of itself.
10. Despite Stakeholder Outcry, CMS Launches Home Health Prior-Authorization Demo
From June 15: Despite outcry from industry stakeholders, advocates and beneficiaries, the CMS is moving forward with a three-year demonstration in which beneficiaries from five states would need to get prior approval before they get home health services.
The demonstration will launch in Florida, Illinois, Massachusetts, Michigan and Texas — states that are all tagged by the CMS as having high levels of improper payments.
|February 24, 2017
||Arizona Chapter Conference
|March 2, 2017
||Ohio Chapter Conference
|March 4, 2017
||Eastern Pennsylvania Chapter Conference
||King of Prussia, PA
|March 9-10, 2017
||South Carolina Chapter Conference
||Hilton Head Island, SC
|March 25, 2017
||Southern California Chapter Conference
||Garden Grove, CA
For the full ACMA event map, click here.
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