On March 24, 2020, multiple Medicare Administrative Contractors (MACs) have announced CMS has extended the due date for cost report filings. The providers covered in this extension include Hospitals, Rural Health Clinics, Federally Qualified Health Centers, Home Health Agencies, and Hospice providers. This extension is a blanket extension, meaning the providers do not need to […]
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Reductions to 340B Payments and Certain Provider-Based Departments and a Delay on Pricing Transparency Rules This past weekend, CMS released the final rule for CY 2020 Outpatient Prospective System (OPPS) Hospital payment that goes into effect on January 1, 2020. There were some diversions from the proposed rule as well as several policies that have […]
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Since HIPAA was originally signed into law in 1996, it has seen five major changes, each intended to make patient information “more safe.” Recently, some clients have been asking us if we think medical records are safer today than before the original HIPAA legislation was passed. Unfortunately, the answer to that question is a resounding […]
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On July 30, 2019, CMS announced the Data at the Point of Care (DPC) pilot program. DPC will give clinicians that are participating in the pilot program access to claims data. Per CMS: “The claims data will fill in information gaps for clinicians, giving them a more structured and complete patient history with information like […]
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What if you began receiving information that described new benefits under your insurance plan that are “free to you.” For example, you receive notice that your insurance company wants you to have an annual wellness visit that focuses on health promotion and disease detection and, by the way, no co-pay. In fact, no financial obligation […]
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With the roll-out of value-based care programs that focus on patient outcomes, health systems and health plans are using telehealth in a proactive way, reaching out to patients facing transitions in care, closing patient gaps in care and tracking treatment adherence for patients with chronic care management plans. Telehealth assists to create care management and […]
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Outsourcing is a common practice in all areas of business, including the healthcare sector. Although this is a major expense for a hospital, it can have an effect on the wage index factor impacting Medicare reimbursement. The wage index factor is determined through a hospital’s wage index average hourly wage which includes both employees on […]
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Beginning July 1, 2019, Medicare will reject hospital outpatient claims if the service location address on the claim does not exactly match the address on record in the Provider-Enrollment, Chain and Ownership System (“PECOS”). Any discrepancies, such as the difference between “Road” vs “Rd” or “Suite” vs “Ste”, may result in substantial payment delays. In MLN Matters […]
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On April 23, 2019, the Centers for Medicare and Medicaid Services (CMS) released the Proposed Rule for the Hospital Inpatient Prospective Payment System (IPPS) for Acute Care Hospitals. The proposed rule includes several significant changes to the wage index calculation impacting the wage index factors and rural floor calculation. It is important to understand and […]
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On April 4, CMS announced that for cost reporting periods beginning on or after October 1, 2019, providers must comply with a “longstanding” rule to claim reimbursement for crossover bad debts from the Medicare program. After this point, providers will be denied reimbursement for their crossover bad debts unless the underlying balances are logged to […]
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By Nancy Orben, CPA, Senior Manager, Laura Philpot, Senior Accountant, Business Services, and Lisa Totten, Senior Accounting Specialist at Blue & Co. Attention all not-for-profit organizations! Are you currently using QuickBooks Point of Sale in your gift shops, ticket sales, or day-to-day business? If so, you may have heard the recent news that Intuit will […]
In the past several years, hospitals have continued to feel the impact of increased utilization of contract nursing and other contract services. Although these services have developed into a major expense line item, it is important for hospitals understand how expenses related to contracted services can impact the wage index factor for Medicare reimbursement. Contract […]
Trusted Insights from The National Bank of Indianapolis Nonprofit Services Team Not-for-profit organizations are increasingly falling victim to fraud, with a rising number of incidents and an ever-growing amount of money being lost. Fraudsters find it easy to target not-for-profits, as their publicly available 990s provide valuable information. Protecting your organization from such fraudulent activities […]
