CMS is automatically reprocessing 2019 hospital claims for certain services provided at grandfathered off-campus provider-based departments (PBD) after a federal judge vacated portions of the 2019 outpatient prospective payment system (OPPS) final rule. However, the agency has filed an appeal and the same federal judge declined to strike down cuts for those services planned for 2020.
As 2019 draws to a close, and as revenue integrity professionals and their organizations look to the future, an important set of decisions and changes await. Among the largest is that to come in 2021 when the new price transparency requirements for hospitals will be in place. CMS finalized the changes in the CY 2020 Hospital Outpatient Prospective Payment System (OPPS) Policy Changes: Price Transparency Requirements for Hospitals to Make Standard Charges Public final rule.
The National Association of Healthcare Revenue Integrity Professionals (NAHRI) has extended its deadline for accepting applications for its board and committees. Taking an active role in NAHRI can set you on the path to shape the future of the revenue integrity profession as well as advance your career.
Medicare made $54.4 million in improper payments to acute care hospitals for post-acute transfers that did not comply with Medicare’s policies, according to a November 1 report from the Office of Inspector General (OIG).
Earning credentials are a career milestone but preparing for the exam is a challenge for even the savviest professional. The Certification in Healthcare Revenue Integrity (CHRI) Practice Exam can help you gain confidence and brush up on your test-taking skills.
The purpose of this policy is to define routine daily hospital services, covered medical and surgical services and supplies, which are sometimes referred to as room and board. This policy is not intended to impact medical practice or care decisions.
