CMS clarifies therapy cap exceptions process for CAHs   02/08/2013
Critical access hospitals will not have to request an exception or use a modifier in order for Medicare to cover outpatient therapy services when a patient has exceeded the annual payment cap on outpatient therapy services, the Centers for Medicare & Medicaid Services has informed the AHA, adding that it could revisit the issue again in the future. While the cost of these services will count toward the beneficiary's annual therapy cap, CMS said it will cover them when provided in a CAH without the need for an exception or modifier on the claim. AHA's critical access members today received a Special Bulletin with more information. The American Taxpayer Relief Act of 2012 extended the therapy cap to CAH outpatient therapy services for calendar year 2013 only.
Hospital groups urge court to review CA Medicaid ruling   02/08/2013
The AHA and eight state hospital associations yesterday filed a friend-of-the-court brief urging the full Ninth Circuit Court of Appeals to review a decision by a three-judge panel of the court, which reversed an injunction to prevent a proposed 10% Medicaid payment cut to hospitals and other health care providers. "Unless the Panel's decision is reconsidered, states within this Circuit will be able to blithely legislate Medicaid rate cuts with CMS imprimatur and with no meaningful judicial oversight, placing hospitals represented by the Amici at great financial risk and reducing access to care for Medicaid beneficiaries," the brief states. The California Hospital Association and other groups requested the en banc review last month. Hospitals that operate skilled nursing units face a 25% cut because the proposed reductions are based on 2008-09 rates. "This case warrants review by the full circuit both because the Panel's decision nullifies solidly reasoned, and longstanding Ninth Circuit precedent, and makes significant public policy based on highly questionable legal assumptions," the amicus brief states. The injunction will remain in effect until the full Ninth Circuit rules on the rehearing request.
CDC: More mothers breastfeeding   02/08/2013
An estimated 75% of infants began breastfeeding in 2008, up from 70% in 2000, according to a new report from the Centers for Disease Control and Prevention. The proportion of infants breastfeeding after 6 months rose nearly 10 percentage points over the period, to 44%, while the proportion breastfeeding after 12 months rose more than 7 percentage points, to 23%. Breastfeeding among African Americans increased nearly 12 percentage points over the period, but whites and Hispanics continued to have higher breastfeeding rates. The American Academy of Pediatrics recommends exclusive breastfeeding for 6 months, followed by continued breastfeeding for at least 12 months as complementary foods are introduced, citing the health benefits for mothers and babies. About 90 hospitals are participating in a CDC-funded initiative to improve breastfeeding support in hospitals. Participants in the Best Fed Beginnings collaborative work with national breastfeeding and quality improvement experts to implement 10 steps to successful breastfeeding established by the World Health Organization/UNICEF Baby Friendly Hospital Initiative.
Study estimates extended impact of Medicare cuts on TN economy   02/08/2013
Existing federal cuts to hospital Medicare payments could cost the Tennessee economy $13.3 billion over 10 years, according to a new study by the Tennessee Hospital Association. Employing a widely used economic impact model, THA estimates that $5.6 billion in projected Medicare cuts to Tennessee hospitals would cost the state more than 90,000 jobs, returning unemployment to its peak level in the recent recession. "Hospitals are very important to their communities in many ways that go beyond providing necessary services to patients," said THA President Craig Becker "…For our state to absorb cuts of this size and scope, without using every possible means to offset the cuts, will create a ripple effect, the likes of which Tennessee communities have never seen before."
CMS, WEDI to host webinar on ICD-10 testing collaborative   02/08/2013
The Centers for Medicare & Medicaid Services and Workgroup for Electronic Data Interchange will host a free webinar Feb. 28 on how to participate in the ICD-10 National Pilot Program, a collaborative established to minimize the guess work related to ICD-10 testing and implementation and share best practices from early adopter organizations. For more information or to register, click here. Health care providers and payers must transition to the ICD-10 diagnosis and procedure codes by Oct. 1, 2014.