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This year’s release includes some changes in both the information released and its classification.

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Guidance on the new sepsis measure (SEP-1) is now available on QualityNet, including what documentation can be used for data elements in the chart-abstracted measure.

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Agencies seek information on quality reporting to help reduce the burden on eligible hospitals and providers; comments are due Feb. 1.

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inpatient

The dry run reports are for a new claims-based outcomes measure that will be included in the IQR Program starting in fiscal year 2018. Hospitals have until Oct. 7 to access this report through QualityNet.

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inpatient

RACs will not conduct postpayment reviews of patient status for Medicare claims with an inpatient admission between Oct. 1 and Dec. 31, 2015.

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inpatient

Agency proposes to reduce slightly payment rates for hospital outpatient services, relax some provisions of the two-midnight policy, and update quality reporting measures.

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Process improvement methodology led to a 40 percent reduction in patient falls at Broward Health Imperial Point after just one year.

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Annual release includes 2013 data related to the 100 most common diagnoses for Medicare patients requiring inpatient stays and 30 selected outpatient procedures.

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The legislation would extend the partial enforcement delay of the two-midnight policy and require CMS to develop new criteria for inpatient stays that last fewer than two midnights. Association President and CEO Bruce Siegel, MD, MPH, said, "It's vitally important that we get this policy right so that we don't inadvertently destabilize hospitals that care for the vulnerable."

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inpatient

CMS stated that MACs must re-review all claims denials under the probe and educate process. CMS also released a new document that provides initial data collected from the inpatient hospital probe and educate reviews.

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The OIG and HHS FY 2014 work plan includes several Medicare and Medicaid projects. These projects cover the following topics including inpatient admission criteria, E&M payments, IME, and provider taxes.

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inpatient

CMS will discuss inpatient hospital admission and medical review criteria and answer questions. A partial delay of the policy was instituted Nov. 5, 2013, and extended Jan. 31. Now recovery audit contractors and Medicare administrative contractors will not conduct postpayment patient status reviews for inpatient admissions with dates of service between Oct. 1, 2013 and Sept. 30, 2014.

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inpatient

CMS posted further guidance extending the partial delay of the two-midnight policy for inpatient admission and medical review through Sept. 30. For inpatient admissions with dates of service between Oct. 1, 2013 and Sept. 30, 2014, recovery audit contractors and Medicare administrative contractors will not conduct postpayment patient status reviews.

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inpatient

Inpatient population and sampling data for chart-abstracted quality measures for the third quarter of 2013 (discharges from July 1 through Sept. 30, 2013) will be due Feb. 8 for the IQR Program. Outpatient population and sampling data and outpatient chart-abstracted measures will be due Feb. 8 for the OQR Program.

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Call will cover inpatient hospital admission, medical review criteria and offer case scenarios

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Revised policy presumes inpatient admissions fewer than two midnights are inappropriate for inpatient reimbursement

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The VBP program links Medicare inpatient payments to quality measure performance

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Offered direction on how to select hospital claims during inpatient probe and educate program

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Rule establishes presumption of medical need for Medicare hospital inpatient admissions that span two midnights

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Cited concerns that hospitals may be undercompensated for providing necessary services that do not meet new criteria

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Will take comment on physician order and certification, medical review criteria, and other issues

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Hospital inpatient quality reporting program intended to provide consumers with quality of care information

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Responds to CMS concern that Medicare and beneficiaries might pay more for outpatient care

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Education targeted at staff involved in reporting summary data to the National Healthcare Safety Network

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Association urges CMS to accurately capture uncompensated care data to implement Medicare DSH cuts

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About America’s Essential Hospitals

America’s Essential Hospitals is the leading association and champion for hospitals and health systems dedicated to high-quality care for all, including the most vulnerable. Since 1981, America’s Essential Hospitals has initiated, advanced, and preserved programs and policies that help these hospitals ensure access to care. We support members with advocacy, policy development, research, and education.

America’s Essential Hospitals was formerly known as the National Association of Public Hospitals and Health Systems (NAPH). Carrying our mission since 1981 into today's health care era

Learn more about the name change »