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Occupational Mix Survey Deadline Extended

CMS has granted an extension for hospitals nationwide to file their Occupational Mix Surveys (OMS). The original due date of July 1, 2020, has been extended to August 3, 2020.

Every three years, the Centers for Medicare and Medicaid Services (CMS) requires any hospital that is subject to the Inpatient Prospective Payment System (IPPS) to complete an OMS. The data collected from these surveys is used to calculate the Occupational Mix Adjustment Factors (OMAF) which will affect your FFY 2022, 2023, and 2024 DRG and APC rates.

Since the survey is only required once every three years, we find that many hospitals have questions about the impact the Occupational Mix Surveys can have on their reimbursement or how CMS uses the surveys. Many times we find that the surveys have been completed inaccurately or are incomplete. In order to optimize your hospital’s reimbursement, it is crucial for your hospital to identify the areas of opportunity and understand how the data needs to be reported.

We would appreciate the opportunity to assist your hospital to identify opportunities and to develop strategies while completing this survey. Please contact Kyle Smith with any questions.

340B Reimbursement Update

Medicare Part B Reimbursement Cuts To 340B Hospitals

In 2018, the Center for Medicare & Medicaid Services (CMS) implemented a change in reimbursement for DSHs, RRCs, and non-rural SCHs for Medicare Part B drugs obtained through the 340B Program, adjusting reimbursement amounts based on a value of Average Sales Price (ASP) – 22.5% from the previous value of ASP + 6%. This was […]

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HEALS Act vs. HEROES Act: Our Comparison

HEALS Act vs. HEROES Act: Our Comparison

On July 27th, Senate Republicans introduced their version of an additional round of economic stimulus and coronavirus response in the form of the Health, Economic Assistance, Liability Protection and Schools (HEALS) Act. In comparison to the Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act introduced by House Democrats back in May, the HEALS Act […]

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PAC Billing Codes

Denied Claims due to Billing Codes

A new issue is affecting some inpatient hospital and Skilled Nursing Facility (SNF) claims when an interrupted stay is billed at the end of the month. The system incorrectly assigns edits U5601-U5608 (overlapping a hospital claim). If you billed the interrupted stay correctly, and your claim is rejected, modify your billing so the claim spans […]

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