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Payment Adjustments for Conditions Acquired in Hospitals
(7/22/2010)
Bulletin discussing payment adjustments for inpatient hospitals with high volumes of "hospital acquired conditions."
Does My County Still Need Long-Term Care Beds?
(7/21/2010)
Will a county’s bed need or excess for the July, 2010 comparative review process change as contiguous county bed relocation projects are implemented?
Maximum Period for Medicare Claims Submission Reduced
(7/20/2010)
Section 6404 of the Patient Protection and Affordable Care Act reduces the maximum allowed time period for submission of Medicare Part A and Part B claims to one calendar year from the date of service
Ohio’s Long-Term Care Bed Prices are Decreasing
(6/14/2010)
The purchase price for the operating rights to long-term care beds in Ohio is decreasing.
New Enforcement Changes with Health Care Reform
(6/2/2010)
Bricker & Eckler bulletin highlighting new enforcement authorities that the federal government now has of which health care providers will want to take note.
CMS Answers Q&A Regarding Physician Supervision
(6/2/2010)
CMS answers common questions about physician supervision requirements.
The Ohio Department of Health Schedules Hearing Date for Pending Rules for the Licensing of Maternity and Newborn Care Units
(6/1/2010)
The Ohio Department of Health proposed new Ohio Administrative Code rules 3701-7-01 to 3701-7-17 for the licensing of maternity units, newborn care nurseries, and maternity homes.
The Ohio Department of Health Approves Certificates of Need for Contiguous County Long-Term Care Bed Relocations
(5/28/2010)
As of May 11, 2010, the Ohio Department of Health has approved seven (7) applications for Certificate of Need for the relocation of long-term care beds from a contiguous county to an existing health c
Public Informational Hearing Requested for Certificate of Need Application
(5/27/2010)
An affected party timely filed a request for a public informational hearing with the Ohio Department of Health over a Certificate of Need application for the relocation of long-term care beds to an ex
In the Market for Long-Term Care Beds in Ohio
(5/26/2010)
Ohio’s Certificate of Need laws recently changed to expand the market for long-term care beds. Providers are no longer limited to selling and acquiring beds from within the county.
Certificate of Need Application for Long-Term Care Bed Relocations in Ohio
(5/20/2010)
The Ohio Department of Health has determined that only one method of bed relocation may be filed per Certificate of Need application.
Timely Filing Limitations for Medicare Have Changed!
(4/27/2010)
As part of the Patient Protection and Affordable Care Act (PPACA) signed into law on March 23, 2010 the time period for filing claims timely has changed.
Medically Unlikely Edits (MUE)
(4/9/2010)
Transmittal 652, Change Request 6712, dated March 17, 2010 addresses Medically Unlikely Edits (MUE).
Results of Ohio's Long Term Care Bed Need Formula Now Available
(4/7/2010)
Results of Ohio’s long-term care bed need formula are now available on our web site at http://www.qmcg.com/services/regulatory/certneed/
Bundling Non-Diagnostic Service
(3/24/2010)
Recently there has been much publicity regarding the bundling of non-diagnostic services by hospitals. Ohio hospitals received information on this from the Ohio Hospital Association and information h
The Ohio Department of Health Revises Hearing Date for Proposed Rules for the Licensing of Maternity and Newborn Care Units
(3/5/2010)
The Ohio Department of Health is proposing new Ohio Administrative Code rules 3701-7-01 to 3701-7-17 for the licensing of maternity units, newborn care nurseries, and maternity homes.
The Ohio Department of Health Proposes Rules for the Licensing of Maternity and Newborn Care Units
(2/25/2010)
The Ohio Department of Health is proposing new Ohio Administrative Code rules 3701-7-01 to 3701-7-17 for the licensing of maternity units, newborn care nurseries, and maternity homes.
15 nursing home beds available for sale in Seneca County, Ohio
(2/16/2010)
15 nursing home beds are available for sale in Seneca County and can be relocated within Seneca County or to an existing nursing home in Wood, Hancock, Wyandot, Crawford, Huron, and Sandusky Counties.
Rehabilitation Changes as of January 2010
(12/21/2009)
Chapter 32 of the Medicare Claims Processing Manual have been revised effective January 4, 2010 to reflect the final OPPS rules for Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Se
Public Health Council Hosts Hearing on Certificate of Need Draft Rules
(12/1/2009)
The Public Health Council will hold a public hearing on January 14, 2010 at
10:00 for Certificate of Need draft rules.
Is the Third Time the Charm? CMS Finalizes Supervision Requirements for Outpatient Hospital Services
(11/20/2009)
Bricker & Eckler Health Care Bulletin on newly released CMS guidance, effective January 1, 2010, modifying the physician supervision requirements for hospital outpatient therapeutic and diagnostic ser
Outpatient Physical Therapy and Occupational Therapy Claim Review by NGS
(9/15/2009)
NGS will begin editing claims based on the current Outpatient Physical Therapy and Occupational Therapy Local Coverage Determination (LCD)
Lipid Profile/Cholesterol Testing
(7/15/2009)
According to National Government Services (NGS) providers have been inappropriately billing a Lipid Panel (CPT code 80061) and a Lipoprotein (CPT code 83721) test for the same patient on the same date
Physician Orders for an Electronic Ordering System
(7/6/2009)
Information regarding "proof of a physican order" for providers who use an electronic ordering system.
CMS Publishes New Modifiers for Outpatient Never Events, Clarifies Hospital Acquired Conditions
(6/19/2009)
Recently, CMS has introduced three new modifiers for use with never events identified by the National Quality Forum (NQF).
New HCPSCS Code: C9899 (Implanted Prosthetic Device, Payable Only for Inpatients Who Do Not Have Inpatient Coverage)
(2/11/2009)
New HCPCS code C9899 (implanted prosthetic device, payable only for inpatients who do not have inpatient coverage) was effective for services furnished on or after January 1, 2009.
Recovery Audit Contractors (RAC)
(2/3/2009)
The RAC program mandated by the Tax Relief and Health Care Act of 2006 will roll-out nationwide no later than January 1, 2010. It is anticipated that Ohio will be one of the last states in Region B to
CMS Quietly 'Clarifies' Rule Related to Physician Supervision of On-Campus Hospital Outpatient Department Therapeutic Services
(1/30/2009)
Bricker & Eckler Health Care Bulletin describing new changes regarding physician supervision for therapeutic services.
The Joint Commission Implements New Conflict Management Standard
(1/26/2009)
A new hospital accreditation standard that addresses conflict management was implemented recently by The Joint Commission ("TJC").
2009 New/Established Patient
(1/23/2009)
Bulletin defining new and established patient defined according to 2009 Final OPPS Rule.
2009 Drug Administration Codes
(1/12/2009)
New drug administration CPT codes effective January 1, 2009.
Medicare Administrative Contractor (MAC) Selected for Ohio
(1/8/2009)
Medicare Administrative Contractor (MAC) Selected for Ohio
Modifier -25
(10/23/2008)
An article was recently published to the National Government Services (NGS) website that should serve as a reminder for billing a visit code with modifier -25.
OIG Issues 2009 Work Plan
(10/7/2008)
Alert discussing OIG's 2009 Work Plan.
Medicare Publishes Medically Unlikely Edits
(10/3/2008)
CMS announced that effective October 1, 2008, most of the medically unlikely edits (MUEs) will be published.
DNV Healthcare Approved by CMS as New Hospital Accrediting Organization
(9/30/2008)
In the September 29, 2008, Federal Register CMS published notice that DNV Healthcare has been approved by CMS as a hospital accrediting organization.
October 2008 Update of OPPS
(9/24/2008)
The October 2008 Update of the Hospital Outpatient Prospective Payment System was released on September 19, 2008, Transmittal 1599
Revised Advanced Beneficiary Notice Form
(8/27/2008)
Discussion of revised ABN form.
Coding Compliance Newsletter - August 2008
(8/18/2008)
Newsletter summarizing the 2009 OPPS proposed rule.
Poliner on Appeal: From $366 Million to $0
(7/25/2008)
On July 23, 2008, the U.S. Fifth Circuit Court of Appeals in Poliner v. Texas Health System reversed the district court’s now infamous ruling in favor of Dr. Poliner and held that HCQIA immunit
Medicare OPPS Proposed Rule for 2009
(7/14/2008)
On July 3, CMS published on its website the Outpatient Prospective Payment System (OPPS) proposed rule for 2009. It is to be published in the Federal Register on July 18.
2009 Joint Commission Standards Released
(7/1/2008)
The Joint Commission has made the 2009 accreditation standards for all programs available online.
Huntsman II: Ohio Courts Continue to Clarify the Peer Review Privilege
(6/27/2008)
The case of Huntsman v. Aultman Hospital, 2005-Ohio-1482 (Huntsman I), was an early decision on the 2003 changes to Ohio's peer review privilege. Huntsman I was significant in clarifying
Implementation of Joint Commission Standard MS. 1.20 Delayed
(6/4/2008)
On June 3, 2008, The Joint Commission announced that the implementation date of revised standard MS.1.20 would be delayed. Revised MS.1.20 will not go into effect on July 1, 2009, as previously planne
Kadlec Revisited
(5/28/2008)
Kadlec Medical Center v. Lakeview Anesthesia, Case No. 06-30745 (5th Cir., 2008) -- The case is new, but the principle is old. The bottom line is simple-- Don't say things you know are not true
Physician Assistant Formulary Finalized
(2/25/2008)
Ohio's new PA Formulary was recently finalized and goes into effect on February 28, 2008.
Medical Board Issues Statement on the Ability of PAs to Order Restraints and Seclusion
(2/13/2008)
The Ohio State Medical Board recently issued a statement on the ability of physician assistants ("PA") to order the restraint and seclusion of patients. The statement is helpful given that both the Me
Joint Commission Announces Task Force to Examine MS. 1.20
(1/4/2008)
In a news release published on January 3, 2008, The Joint Commission announced that it had appointed a 16-member Task Force to "examine implementation issues" related to the controversial revised Medi
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