CMS extends two-midnight partial enforcement delay   02/03/2014
The Centers for Medicare & Medicaid Services Friday extended for six months the partial enforcement delay of its two-midnight policy for inpatient admission and medical review criteria. Under the extension, recovery auditors and other Medicare review contractors will not conduct post-payment patient status reviews of inpatient hospital claims with dates of admission on or after Oct. 1, 2013 through Sept. 30, 2014. However, Medicare Administrative Contractors will continue to conduct pre-payment “probe and educate” audits on select claims for patients admitted between Oct. 1, 2013 and Sept. 30, 2014. For more on the claims review policy, see CMS’ updated guidance. “We are pleased that CMS has extended its enforcement moratorium on the two-midnight policy for an additional six months, as the AHA has urged,” said AHA Executive Vice President Rick Pollack. “…At the same time, we continue to urge CMS to fix the critical flaws of the underlying policy by immediately engaging stakeholders to find a workable solution that addresses the reasonable and necessary inpatient-level services currently provided by hospitals to Medicare beneficiaries that are not expected to span two midnights.” CMS also posted new guidance clarifying its physician certification and order requirements under the two-midnight policy. The agency will answer questions about the two-midnight policy during a Special Open Door Forum conference call tomorrow at 1 p.m. Eastern Time, and a Medicare Learning Network call on Feb. 27 at 2:30 p.m. ET. Details on the Feb. 27 call will be posted at www.cms.gov. AHA members today received a Special Bulletin with more information on these developments.
CMS delays inpatient, outpatient quality reporting deadlines   02/03/2014
The Centers for Medicare & Medicaid Services Friday delayed to Feb. 8 the deadline for reporting certain third-quarter 2013 quality data to the Medicare inpatient and outpatient quality reporting programs. The one-week delay affects inpatient population and sampling data for chart-abstracted quality measures, outpatient population and sampling data, and outpatient chart-abstracted measures. The delay was prompted by severe weather in the Southeast, but applies to all hospitals participating in the programs. Hospitals with questions about the delay should contact their state Quality Improvement Organization for more information. Other questions about the quality programs should be directed to the QualityNet help desk at (866) 288-8912.
HHS final rule gives patients direct access to lab reports   02/03/2014
The Department of Health and Human Services today issued a final rule allowing laboratories to give patients or their designated representative access to completed test reports on request. While patients can continue to get access to their laboratory test reports from their doctors, the rule amends the Clinical Laboratory Improvement Amendments of 1988 regulations and Health Insurance Portability and Accountability Act Privacy Rule to give patients a new option to obtain their test reports directly from the laboratory. In a November 2011 comment letter on the proposed rule, AHA said the change would remove barriers to the exchange of health information and allow patients to play a more active role in their personal health care decisions. The rule takes effect 60 days after publication in the Feb. 6 Federal Register. HIPAA-covered entities will have 240 days to comply with the published rule’s applicable requirements.
CMS to test new integrated care models for CAHs in frontier areas    02/03/2014
Critical access hospitals in Alaska, Montana, Nevada, North Dakota and Wyoming can apply through May 5 to participate in a Medicare demonstration to develop and test new models of integrated, coordinated health care in sparsely populated rural counties, the Centers for Medicare & Medicaid Services announced Friday. According to CMS, the Frontier Community Health Integration Project will support CAHs in increasing access to services that are often unavailable in frontier communities with the goal of reducing avoidable transfers to hospitals in larger communities. Applications should include a plan to meet health needs in the areas of telemedicine, nursing facility care, home health and ambulance services. For more information, visit http://innovation.cms.gov.
AHA webcast to reveal new hospital quality achievements   02/03/2014
Log on to the next AHA Town Hall Webcast on Wednesday at 10 a.m. Eastern Time to learn the latest achievements of the AHA’s Health Research & Educational Trust Hospital Engagement Network. AHA, CMS and hospital leaders will discuss highlights from the network’s new annual report, which shows substantial cost-savings over the past two years thanks to major reductions in infections, premature births, patient falls, pressure ulcers and avoidable readmissions. Click here to register or call (800) 424-4301 for more information.
Medicare stops enrolling new HH, ambulance providers in some areas   02/03/2014
The Centers for Medicare & Medicaid Services last week announced a six-month moratorium on new Medicare home health agencies in the Fort Lauderdale, FL; Detroit; Dallas; and Houston areas. In addition, CMS extended for six months an existing moratorium on new Medicare HH agencies in Chicago and Miami; announced a Philadelphia-area moratorium on new ground ambulance suppliers in the Medicare, Medicaid and Children’s Health Insurance Programs; and extended for six months a similar moratorium on Houston-area ambulance suppliers. The agency cited fraud trends and risk factors in the affected areas, including a disproportionate number of providers and suppliers and high utilization. CMS does not expect the moratoria, which took effect Friday, to affect access to care but said it will continue to monitor the situation with affected states. It also said the moratoria may be lifted early or extended.
AHA call for trustee nominations closes Feb. 25   02/03/2014
The AHA seeks hospital and health system trustees to serve on its Committee on Governance, Regional Policy Boards, and other governing councils and committees beginning in 2015. Interested trustees are invited to submit an application through Feb. 25. For more information, see the AHA call for nominations or contact Rita Harmata, director of trustee and community leadership, at rharmata@aha.org. For more on trustee involvement opportunities, visit www.aha.org/trusteeopportunities.