"NOTICE Act"

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Hospitals are facing a March 8, 2017 deadline to begin using the new Medicare Outpatient Observation Notice (MOON) to inform Medicare beneficiaries when they are outpatients receiving observation services and not inpatients of the hospital.  The notice is required by the Notice of Observation Treatment and Implication for Care Eligibility Act (NOTICE Act). 

The Centers for Medicare & Medicaid Services (CMS) has released its final rule to update Medicare acute hospital inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system (PPS) payments and policies for fiscal year (FY) 2017.  With regard to the IPPS, CMS projects that the cumulative rate and policy changes in the final rule will increase total IPPS payments by about $746 million in FY 2017 compared to FY 2016. The rule provides a 0.95% operating payment rate update for hospitals that submit quality data and are meaningful users of Electronic Health Records (EHRs).  This update reflects a 2.7% market basket update, adjusted by a -0.3 percentage point multi-factor productivity (MFP) adjustment and an additional -0.75 percentage point adjustment (as mandated by the Affordable Care Act, or ACA), resulting in a 1.65% update.  This update is subject to an additional -1.5 percentage point documentation and coding recoupment adjustment (required by the American Taxpayer Relief Act of 2012) and a one-time increase of approximately 0.8 percentage points to permanently negate the cumulative impact of a “Two Midnight Policy” adjustment adopted in the final FY 2014 rule.
Continue Reading CMS Finalizes FY 2017 Update to Medicare IPPS, LTCH PPS Rates and Policies

CMS has published its proposed rule to update the Medicare acute hospital inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system (PPS) for fiscal year (FY) 2017.

With regard to the IPPS, CMS projects that the cumulative rate and policy changes in the proposed rule would increase total IPPS payments by about $539 million in FY 2017 compared to FY 2016. The proposed rule would provide for a 0.9% operating payment rate update for hospitals that submit quality data and are meaningful users of Electronic Health Records (EHRs).  This update reflects a 2.8% market basket update, adjusted by a -0.5 percentage point multi-factor productivity (MFP) adjustment and an additional -0.75 percentage point adjustment (as mandated by the Affordable Care Act, or ACA), resulting in a 1.55% update to standardized amounts.  This update is subject to an additional -1.5 percentage point documentation and coding recoupment adjustment required by the American Taxpayer Relief Act of 2012, and a one-time increase of approximately 0.8 percentage points to permanently negate the cumulative impact of a controversial “Two Midnight Policy” adjustment adopted in the final FY 2014 rule.
Continue Reading CMS Proposes FY 2017 Update for Medicare IPPS, LTCH PPS Rates and Policies

On December 21, 2015, CMS is hosting a “TeleTown Hall” on implementation of the Notice of Observation Treatment and Implication for Care Eligibility Act (NOTICE Act). The NOTICE Act, enacted in August 2015, requires hospitals and critical access hospitals to provide notification to Medicare beneficiaries receiving observation services as outpatients for more than 24…

On August 6, 2015, President Obama signed into law H.R. 876, the Notice of Observation Treatment and Implication for Care Eligibility Act.  The new law requires hospitals to provide written and oral notification to Medicare beneficiaries receiving observation status for more than 24 hours, rather than admitted as inpatients, beginning 12 months after the…