Request is to invoke emergency powers to issue an 1135 disaster and emergency waiver of certain regulations.
As updates on the COVID-19 pandemic change day by day, and the number of cases in the U.S. climbs, hospitals are starting to see the effects. In Seattle, it has been reported that there are patients in 10 nursing homes that are infected with COVID-19, leading to speculation that the number of patients requiring hospital care and possibly intensive care will increase.
There are also reports from Italy that the healthcare system is getting overwhelmed, accompanied by shortages of critical care beds and ventilators.
In response to this pandemic, the American Hospital Association (AHA) has asked President Trump and the U.S. Department of Health and Human Services (HHS) to invoke their emergency powers to issue an 1135 disaster and emergency waiver of certain regulations. The AHA has asked for three specific items: first, a waiver of the requirement for a three-day inpatient admission for a Medicare beneficiary to gain access to Part A skilled nursing facility (SNF) benefits. This will allow offloading of hospitalized patients who can be safely cared for in a SNF, where they can receive skilled medical care under the direction of licensed practitioners, including intravenous therapy, nebulizers, and other complex care.
The AHA also has requested the waiver of the 25-inpatient bed limit for critical access hospitals (CAHs), along with waiver of the 96-hour average length of stay (LOS). Many health systems own or affiliate with CAHs in locations that do not have the density of major cities, and the ability to use these beds for less seriously ill patients could also alleviate potential bed shortages in urban areas.
Finally, the AHA has requested that physicians and other licensed practitioners be able to practice in states in which they are not licensed. Healthcare workers are not immune to infection, even with optimal use of personal protective equipment, since patients may be asymptomatic at the onset of illness. If healthcare workers are exposed and must self-isolate for 14 days, a shortage of physicians would have devastating consequences. Allowing national organizations to redeploy practitioners across state borders would be critical if this disease spreads.
The Centers for Medicare & Medicaid Services (CMS) has been keeping the provider community up to date with multiple press releases per day, and it is hoped that they will quickly respond to this request. The parameters of such waivers are unknown, if they are indeed approved, so it would be premature to start transferring patients to SNFs or to CAHs.
This is a developing story. RACmonitor will continue to report on the coronavirus.
Programming Note: Listen to Dr. Hirsch’s live reporting every Monday on Monitor Mondays, 10-10:30 a.m. EST.
Medicare, like many other insurers, often pays doctors a standardized rate based on the service they performed. Open heart surgery costs $X, a blood test
Worth a second read considering the fatal shooting of the CEO for United Healthcare. The Centers for Medicare & Medicaid Services (CMS) has outlined critical
Please log in to your account to comment on this article.
Join Beth Wolf, MD, CPC, CCDS, for an in-depth webcast on the FY2025 spinal fusion MS-DRG updates. Discover key changes in DRG classification, understand impacts on documentation and CMI, and learn strategies to ensure compliance.
Join Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, as she presents effective strategies to strengthen collaboration between CDI, coding, and quality departments in acute care hospitals. Angela will also share guidance on implementing cross-departmental meetings, using shared KPIs, and engaging leadership to foster a culture of collaboration. Attendees will gain actionable tools to optimize documentation accuracy, elevate quality metrics, and drive a unified approach to healthcare goals, ultimately enhancing both patient outcomes and organizational performance.
Optimize your outpatient clinical documentation and gain comprehensive knowledge from foundational practices to advanced technologies, ensuring improved patient care and organizational and financial success. This webcast bundle provides a holistic approach to outpatient CDI, empowering you to implement best practices from the ground up and leverage advanced strategies for superior results. You will gain actionable insights to improve documentation quality, patient care, compliance, and financial outcomes.
Enhancing outpatient clinical documentation is crucial for maintaining accuracy, compliance, and proper reimbursement in today’s complex healthcare environment. This webcast, presented by industry expert Angela Comfort, DBA, RHIA, CDIP, CCS, CCS-P, will provide you with actionable strategies to tackle complex challenges in outpatient documentation. You’ll learn how to craft detailed clinical narratives, utilize advanced EHR features, and implement accurate risk adjustment and HCC coding. The session also covers essential regulatory updates to keep your documentation practices compliant. Join us to gain the tools you need to improve documentation quality, support better patient care, and ensure financial integrity.
Dr. Ronald Hirsch provides critical details on the new Medicare Appeal Process for Status Changes for patients whose status changes during their hospital stay. He also delves into other scenarios of hospital patients receiving custodial care or medically unnecessary services where patient notifications may be needed along with the processes necessary to ensure compliance with state and federal guidance.
Healthcare organizations face complex regulatory requirements under the No Surprises Act and Price Transparency rules. These policies mandate extensive fee disclosures across settings, and confusion is widespread—many hospitals remain unaware they must post every contracted rate. Non-compliance could lead to costly penalties, financial loss, and legal risks. Join David M. Glaser Esq. as he shows you how to navigate these regulations effectively.
Protect your facility from unwanted audits! Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, and take a deep dive into both the CMS and AMA guidelines for reporting post operative pain blocks. You’ll learn how to determine if the nerve block is separately codable with real life examples for better understanding. Becky will also cover how to evaluate whether documentation supports medical necessity, offer recommendations for stronger documentation practices, and provide guidance on educating providers about documentation requirements. She’ll include a discussion of appropriate modifier and diagnosis coding assignment so that you can be confident that your billing of post operative pain blocks is fully supported and compliant.
During this RACmonitor webcast Dr. Ronald Hirsch spotlights the areas of the OIG’s Work Plan and the findings of their most recent audits that impact utilization review, case management, and audit staff. He also provides his common-sense interpretation of the prevailing regulations related to those target issues. You’ll walk away better equipped with strategies to put in place immediately to reduce your risk of paybacks, increased scrutiny, and criminal penalties.
Copyright © 2024 ICD10monitor. Powered by MedLearn Media.
Prepare for the 2025 CMS IPPS Final Rule with ICD10monitor’s IPPSPalooza! Click HERE to learn more
Get 15% OFF on all educational webcasts at ICD10monitor with code JULYFOURTH24 until July 4, 2024—start learning today!
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
