Practice Management Alert

Payer Updates:

Stop Billing Medicare for 3 More Preventable Conditions

Plus, find out the potential repercussions of not being HIPAA-compliant

As part of the new "present on admission" rules related to hospital charges, CMS announced it will no longer pay for extra care for "serious reportable events." The Federal Register's final acute care inpatient prospective payment (IPPS) rule, published on August 19, adds three conditions to last year's list of conditions "determined to be reasonably preventable through proper care," according to the AMA.

The three additional conditions are:

- Surgical site infections following certain elective procedures, including certain orthopedic surgeries and bariatric surgery for obesity

- Certain manifestations of poor control of blood sugar levels

- Deep vein thrombosis or pulmonary embolism following total knee replacement and hip replacement procedures.

In Other News:

CMS announced that one health plan had to pay a $100,000 "resolution" to the Dept. of Health and Human Services (HHS) for violating patients- protected health information (PHI). You can read the details of this action at http://www.hhs.gov/ocr/privacy/enforcement/. Stay tuned to Medical Office Billing & Collections Alert for information on ensuring your practice won't be the next HIPAA-violation victim.

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