The 2019 Medicare Physician Fee Schedule (MPFS) proposed rule, released July 12, introduces policies that focus on expanding the framework for reporting E/M visits and removing certain process measures under the Quality Payment Program (QPP).
The Surviving Sepsis Campaign recently released a 2018 update to guidelines for the care of patients with sepsis. The update includes a new “hour-one bundle” which replaces previous versions of the Surviving Sepsis Campaign guidelines.
On June 18, the World Health Organization (WHO) released a version of the 11th Revision of the International Classification of Diseases (ICD-11). ICD-11 reflects critical advances in science and medicine and is the first code set revision to be well integrated with electronic health applications and information systems, WHO says.
Despite considerable opposition from hospital systems, on June 1, the Health Resources and Services Administration finalized its decision to delay the implementation of a 340B rule on drug ceiling prices and civil monetary penalties for manufacturers.
At the 2018 American Hospital Association (AHA) Annual Membership Meeting on Monday, May 7, CMS administrator Seema Verma focused on the agency’s efforts to reduce regulatory burdens and continued move from a fee-for-service to value-based system.
CMS released the fiscal year (FY) 2019 IPPS proposed rule on Tuesday, April 24, with significant reductions to reporting requirements for quality initiatives and expected ICD-10-CM/PCS code and MS-DRG updates.
While oral arguments in the American Hospital Association’s (AHA) lawsuit against CMS for its cuts to 340B drug payments in the 2018 OPPS final rule don’t begin until May 4, providers may want to take steps now to preserve their appeal rights if the AHA’s lawsuit is successful.
Systemic inflammatory response syndrome (SIRS) criteria has a greater sensitivity than quick sepsis-related organ failure assessment (qSOFA) as a screening test to initiate treatment for sepsis in non-intensive care unit patients, according to the recent study published in the Annals of Internal Medicine.
CMS held a listening session March 21 to gather input from stakeholders on potential updates to the E/M documentation guidelines. The current guidelines are considered outdated in light of medical advances and the advent of the electronic health record.
Of emergency department visits attributable to ruptured abdominal aortic aneurysm, acute myocardial infarction, stroke, aortic dissection, and subarachnoid hemorrhage, the conditions were not accurately diagnosed approximately one out of 20 times, according to a study by the Journal of the American Medical Association (JAMA) .
In response to ongoing criticism from physicians and the government’s own advisory panel against the Medicare Access and CHIP Reauthorization Act (MACRA), the U.S. House Committee on Ways and Means Subcommittee on Health held a hearing Wednesday, March 21, to defend the administration’s implementation strategy for the new physician payment program.
An Office of Inspector General (OIG) audit of the University of Michigan Health System revealed noncompliance with four types of inpatient claims, including those associated with the billing of high-severity-level MS-DRGs.
CMS released Transmittal 3997 March 8, outlining HCPCS drug and biological code updates. These changes include updates to specific biosimilar biological product HCPCS codes, modifiers used with these biosimilar biologic products, and an autologous cellular immunotherapy treatment.
The cost for a hospital stay in 2014 involving acute renal failure (ARF) averaged $19,200, nearly twice the $9,900 average cost for stays not involving renal failure, according to the statistical brief published by The Healthcare Cost and Utilization Project (HCUP).