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Issue #129 - July 15, 2009
AAPC EdgeBlast

2010 OPPS, ASC Policy and Payment Changes
The Centers for Medicare & Medicaid Services (CMS) proposed, July 1, several policy and payment rate changes for hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs) for fiscal year 2010. Payment rate increases for providers paid under the Outpatient Prospective Payment System (OPPS) and expanded coverage for certain Medicare services furnished in HOPDs and ASCs are projected in the 2010 proposed rule.

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2010 PQRI Proposed Rule Changes
The Centers for Medicare & Medicaid Services (CMS) released, July 1, Physician Quality Reporting Initiative (PQRI) changes for the Calendar Year (CY) 2010. There are a number of proposed reporting options and reporting periods available. Some options require data submission by Dec. 31, 2010. Data reported through registries, however, is not due to CMS until 2011.

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Stark Law Changes Impose Further Limitations
The  2009 Medicare Inpatient Prospective Payment System (IPPS) final rule includes several significant changes to the Stark law that are slated to go into effect Oct. 1.

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OIG: Chemo Admin Claims Slip Through System
The Office of Inspector General (OIG) is recommending the Centers for Medicare & Medicaid Services (CMS) do more to ensure Medicare Part B claims for chemotherapy administration services are appropriate.

This recommendation was prompted after the OIG was unable to determine whether Medicare appropriately paid for Part B services billed as chemotherapy administration from 2005 to 2007 because of "insufficient" data.

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HHS Rescinds Medicaid Regulations
Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced June 29 that the administration will rescind all or part of three Medicaid regulations and delay the enforcement of a fourth regulation.

Secretary Sebelius said the actions "are necessary to ensure that the states have the flexibility they need to fully serve Medicaid-eligible individuals."

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Health Centers Receive $851M for Expansion
First Lady Michelle Obama announced June 29 the release of $851 million in stimulus funds for community health centers to fulfill equipment needs and attain expansion goals.

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Nurse Gets Nine Years for Health Care Fraud
A registered nurse was sentenced June 29 to nine years in prison and ordered to pay $2.6 million in restitution for health care fraud, federal law officials announced.

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Coding Tips
J9 MAC Posts LCD Revisions
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Bone Up on New I-9 Ortho Codes
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CCI v.15.2 Corrects Bundling Error
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New Date for Billing Routine Cost of Clinical Trials
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Medical News

Review WellPoint/Anthem Contracts Today
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CDC Launches Public Health Tracking Network
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Ohio Court Rules to Disclose Medical Records
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Generic Plan B Approved by FDA
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New Guidelines for Treating Pregnant Women with HINI
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Do You Have an EMR Story?
Do any of you have a story to tell about the purchase of an EMR system for your practice? How long did it take to install? How much did it cost? Was it easy to use? Has it accomplished what you wanted? Are your physicians seeing the same, more or less patients per day since? Do the physicians like it? Wed love to hear from you! Please send your stories directly to reed.e.pew@aapc.com

Test Yourself Online
The Test Yourself questions can be accessed online at www.aapc.com/testyourself/. Once you go there and take the test, you can automatically grade your answers, correct any mistakes, and have your CEUs automatically added to your CEU Tracker for submission.

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Featured Items
2010 OPPS
2010 PQRI
Stark Law Changes
Chemo Admin Claims
Medicaid Regulations
Centers Receive $851M
Nurse Gets Nine Years
Coding Tips
Medical News
Test Yourself Online
Coding Job Links

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