MHA Today | November 8, 2016

November 8, 2016

MHA Today: News for Healthcare Leaders

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In This Issue
CMS Releases Final CY 2017 PFS And Other Part B Services
MO HealthNet Issues Hospice Bulletin
CMS Announces VBP Webinar

Conducting a Proactive Risk Assessment: Failure Mode Effects and Critical Analysis

Tuesday, Nov. 29
10-11:30 a.m.

Regulatory News
the latest actions of agencies monitoring health care

CMS Releases Final CY 2017 PFS And Other Part B Services

Staff Contact: Andrew Wheeler

Last week, the Centers for Medicare & Medicaid Services announced that the calendar year 2017 physician fee schedule and other Part B service payment and policy updates have been finalized. MHA has published an issue brief with additional information. The rule outlines many changes, including the following.

  • PFS
    • telehealth services
    • phase-in of significant relative value unit reductions
    • payment incentive for the transition from traditional X-ray imaging to digital radiography and other imaging services
    • therapy caps

  • Other items
    • federally qualified health center revisions
    • appropriate use criteria for advanced diagnostic imaging services
    • release of Part C Medicare Advantage bid pricing data
    • Medicare Part C and D medical loss ratio data
    • proposed expansion of the diabetes prevention program model
    • value-based payment modifier and physician feedback program

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MO HealthNet Issues Hospice Bulletin

Staff Contact: Sarah Willson

MO HealthNet has released a hospice-related provider bulletin that explains changes with the annual rate increase, service intensity add-on payments and upcoming webinars. Hospice providers are required to differentiate between nursing visits using special modifier codes. The Centers for Medicare & Medicaid Services has established two procedure codes for providers to distinguish between registered nurse services: G0299 (direct skilled nursing services of an R.N. in the home health or hospice setting) and licensed practical nurse services: G0300 (direct skilled nursing of an LPN in the home health or hospice setting). The procedure code for social work services is G0155 (medical social service visit). Procedure codes are required for reporting purposes on the claim to determine if a hospice provider should receive an SIA payment. Because of system update requirements, the MO HealthNet Division will generate retrospective quarterly reports to determine the SIA payment, which will be paid to providers manually, not through the regular claims system.

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Quality and Population Health

CMS Announces VBP Webinar

Staff Contact: Sherry Buschjost

An outreach and education webinar for participants in the Hospital Value-Based Purchasing Program is scheduled at 1 p.m. Tuesday, Nov. 15. The webinar, titled “HCAHPS: Overview, Updates and Hospital Value-Based Purchasing Program,” will provide an overview of the following topics: background of Hospital Consumer Assessment of Healthcare Providers and Systems survey; trends of HCAHPS measures; HCAHPS and VBP with a review of the care transition measure dimension added to hospital VBP and the pain management dimension removed from hospital VBP; and HCAHPS correlations. Registration is required.

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Consider This ...

Influenza activity generally begins to increase in October and peaks between December and March. Long flu seasons can last through May.

Source: Centers for Disease Control and Prevention