CMS issues proposed IRF payment rule for FY 2014   05/03/2013
The Centers for Medicare & Medicaid Services yesterday issued a proposed rule increasing Medicare payments for inpatient rehabilitation facilities by 2% ($150 million) in fiscal year 2014. The net increase includes a marketbasket update of 2.5%, minus a 0.4% productivity adjustment and 0.3 percentage point reduction mandated by the Patient Protection and Affordable Care Act, plus a 0.2% increase due to proposed outlier payment changes. In addition, the regulation would modify the process used to assess IRF compliance with the “60% Rule,” which requires 60% of an IRF’s cases for the prior 12-month compliance period to fall within 13 qualifying conditions. The proposed rule would require new, more specific codes for the patient’s condition, severity of illness, and anatomical location of illness so CMS contractors can more accurately assess a facility’s compliance with the 60% Rule. Currently, the agency often estimates 60% Rule compliance since the policy does not fully align with IRF coding. CMS said it expects all facilities will be able to adapt to the new coding approach and that it does not expect the proposal to affect net Medicare payments to IRFs. The rule will be published in the May 8 Federal Register with comments accepted through July 1.
CMS urged to clarify rules for unofficial Marketplace assisters   05/03/2013
The AHA today commended the Centers for Medicare & Medicaid Services for proposing standards for “navigators” and others who help uninsured consumers enroll in health coverage through the Health Insurance Marketplace beginning in October, but urged the agency to clarify the role, responsibilities and requirements for those who provide voluntary assistance, without federal financial support. “We do not wish to see any disincentives for hospitals or others to lend their hands to the task of enrolling individuals in health coverage,” wrote AHA Executive Vice President Richard Pollack in comments submitted today. The letter also recommends that CMS consolidate consumer assistance programs and standards under the Patient Protection and Affordable Care Act “into one set of rules that provide greater clarity on which entities can perform which functions, and which standards apply to each type of assister.” In addition, AHA urged CMS to make consumer or beneficiary information available in the 15-20 most frequently encountered languages, “to avoid duplicative costs at the local level.”
AHA participates in HHS listening session on EHRs and coding   05/03/2013
The Centers for Medicare & Medicaid Services and Office of the National Coordinator for Health Information Technology today hosted a “listening session” on billing and coding with electronic health records. Presenting at the event, AHA Chairman Benjamin Chu, M.D., regional president for Southern California of Kaiser Foundation Health Plan and Hospitals, said EHRs “improve care by allowing doctors to collect a more complete set of information about their patients and make that information actionable. Hospitals take very seriously their responsibility to document care and submit accurate claims. As we increase use of EHRs, we need to open the black box and know that these tools support compliant coding.” Chu said the Department of Health and Human Services should provide guidance and oversight to ensure that EHR vendors support compliance with coding conventions and guidelines. He also encouraged HHS to work with hospitals to develop national coding guidelines for the emergency department, noting that education for vendors and providers will be key to establishing a common understanding of the rules and best practice.
Hospitals add 2,700 jobs in April   05/03/2013
Employment at the nation's hospitals rose by 0.06% in April to a seasonally adjusted 4,836,200 people, the Bureau of Labor Statistics reported today. That's 2,700 more people than in March and 57,700 more than a year ago. Without the seasonal adjustment, which removes the effect of fluctuations due to seasonal events, hospitals employed 4,826,000 people in April – 5,200 more than in March and 57,200 more than a year ago. The nation's overall unemployment rate fell by 0.1 percentage point in April to 7.5%.
Replay of AHA Town Hall webcast on Enroll America available   05/03/2013
A replay of Tuesday’s AHA Town Hall Interactive webcast on Enroll America is available to members online. Panelists reviewed Enroll America activities and resources for hospitals, important upcoming dates, and strategies and challenges for hospitals as they look to help patients enroll in the new health insurance exchanges.