Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule Overview On November 2, 2021, CMS released the anticipated CY 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center...

 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed Rule Overview On July 19, 2021, CMS released the anticipated CY 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical...

 BFCC-QIO National Claim Review Contract Awarded for Short Stay and Higher-Weighted Diagnosis Related Group (HWDRG) Claims Overview Livanta, a Centers for Medicare & Medicaid Services’ (CMS) Beneficiary and Family Centered Care – Quality Improvement Organization...

Elimination of the Inpatient-Only List Regulatory and Operational Compliance Considerations    Overview The CY 2021 Medicare Hospital Outpatient Prospective Payment System (OPPS) Final Rule[1] included the Inpatient Only (IPO) List phase-out over 3 years. Over...

  CY 2021 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS-1736-FC) Executive Summary of Final Rule On December 2, 2020, the Centers for Medicare & Medicaid Services (CMS) released the...

CMS FY 2021 IPPS & LTCH Final Rule (CMS-1735-F) Executive Summary of Changes On September 2, 2020, the Centers for Medicare & Medicaid Services (CMS) published the FY 2021 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Acute Care...

Blanket Waiver of the Utilization Review Standards of the Condition of Participation Does NOT Waive Beneficiary Rights & Condition Code 44 Billing Requirements!   Last week, the Centers for Medicare and Medicaid Services (CMS) waived “the entire utilization...

Versalus Health’s Comments on CMS’ Waivers to Utilization Review Conditions of Participation On March 30, 2020, the Centers for Medicare and Medicaid Services (CMS) published additional blanket waivers in response to the COVID-19 pandemic. There are a number of...

COVID-19-Related Considerations When Determining Medicare & Medicare Advantage Admission Status 1. Public Health Emergency Declarations As utilization review and compliance experts within your hospitals, it is imperative that you understand the impact that waivers...

Versalus Health’s Comments on CMS’ Revisions to Requirements for Discharge Planning for Hospitals On September 30, 2019, the Centers for Medicare & Medicaid Services (CMS) published a new Final Rule, Revisions to Discharge Planning Requirements (CMS-3317-F). The...