Oakland University
Tuesday, October 29, 2013

AAMC/grr Update

To: All GRRs

RE: CMS Message on Pending Regulations


CMS posted the following message (also copied below) regarding the timing of pending regulations: http://www.cms.gov/Center/Provider-Type/Hospital-Center.html?redirect=/center/hospital.asp

For questions or more information, please contact Allison Cohen at acohen@aamc.org or 202-862-6085.


 ,        Although we are still assessing the impact of the partial government shutdown on completion of the calendar year 2014 Medicare fee for service payment regulations, we intend to issue the final rules on or before November 27, 2013, generally to be effective on January 1, 2014. The impacted regulations include:

Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (CMS-1526-F)

CY 2014 Changes to the Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System (CMS-1601-FC)

CY 2014 Home Health Prospective Payment System Final Rule (CMS-1450-F)

Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2014 Final Rule with Comment Period (CMS-1600-FC)

·         New Guidance on the Physician Order and Physician Certification for Hospital Inpatient Admissions
On August 19, 2013, in the FY2014 IPPS/LTCH final rule CMS clarified and revised the conditions of payment for hospital inpatient services under Medicare Part A related to patient status. This document provides additional guidance on the provisions of the final rule regarding the physician order and physician certification of hospital inpatient services, which are required for Part A payment.

·         New Materials Available for Hospital Outpatient Prospective Payment System Proposed Rule
CMS has posted corrected addenda, cost statistics files, an impact file, and an impact table for the CY 2014 Hospital Outpatient Prospective Payment System (OPPS) Proposed Rule (CMS-1601-P). These corrected files are available on the Hospital Outpatient PPS website. More information about the proposed rule is available on the Hospital Outpatient Regulations and Notices web page.

·         Deadline for LTCH/IRF 1st Quarter Quality Data Extended to Friday August 23

CMS is extending the deadline for Long-Term Care Hospitals (LTCHs) and Inpatient Rehabilitation Facilities (IRFs) submitting first quarter 2013 (January – March) quality data to 11:59:59 p.m. on August 23, 2013. The original deadline was 11:59:59 on August 15, 2013. Due to data submission challenges with both CMS reporting and the National Healthcare Safety Network systems, the extension applies to both clinical data and data on healthcare-associated infections.

·         CMS Rule 1599-F: Inpatient Hospital Admission and Medical Review Criteria (2-Midnight Provision) and Part B Inpatient Billing in Hospitals

CMS hosted a Special Open Door Forum (ODF) call to allow hospitals, practitioners, and other interested parties to give feedback on the physician order and physician certification, inpatient hospital admission and medical review criteria, and Part B inpatient billing provisions that were released on August 2, 2013 in the FY 2014 Inpatient Prospective Payment System (IPPS) final rule (CMS-1599-F). This introductory call allowed for initial discussions between stakeholders and CMS. The transcript and MP3 audio file will be posted to the Special ODF webpage under the "Downloads" section around August 22 and will be available for 30 days. CMS understands that providers or associations may have additional questions or concerns. You are encouraged to submit questions related to the two midnight provision for admission and medical review to the IPPSadmissions@cms.hhs.gov mailbox. Questions on Part B inpatient billing and the clarifications regarding the physician order and certification should be sent to the subject matter staff listed in the final rule. CMS will review stakeholder feedback as quickly as possible and provide responses and clarification as needed.

For more information:

FY 2014 IPPS Rule Outreach

Final Rule (CMS-1599-F)

Created by Claudia DiMercurio (dimercur@oakland.edu) on Tuesday, October 29, 2013
Modified by Claudia DiMercurio (dimercur@oakland.edu) on Tuesday, October 29, 2013
Article Start Date: Tuesday, October 29, 2013