Healthcare Financial News

The Centers for Medicare and Medicaid Services (CMS) announced that it has instructed its contractors to hold claims for physicians, nonphysician practitioners, and other fee-for-service (FFS) providers paid under the Medicare physician fee schedule for the first 10 business days of July. All claims for services delivered on or before June 30 will be processed and paid under normal procedures.

After 10 business days, contractors will begin releasing claims into processing under the fee schedule which implements current law--which could result in claims being processed with the negative 10.6 percent update. If a new law is enacted which changes the update, retroactive to July 1, CMS said it is prepared to automatically reprocess most of those claims. To the extent possible, providers may hold claims in-house until it becomes clearer as to whether new legislation will be enacted or until cash flow becomes problematic.

As part of its Standards Improvement Initiative launched in 2006, the Joint Commission has revised standards, rationales, and elements of performance for 2009. The standards, to take effect Jan. 1, 2009, have been placed online to give all healthcare organizations time to become familiar with the new language, ordering, and numbering.

No new requirements have been added; however, chapter overviews, standards, introductions, rationales, and elements of performance have been redesigned for ease of use, and requirements have been split or consolidated. Also, standards have been renumbered and reordered to allow electronic sorting as well as the addition of new requirements in the future. A history tracking report is available online to help organizations see what happened to each standard, its new number, and how it changed.

Phase 1 of the initiative has focused on the accreditation programs for hospitals, critical access hospitals, ambulatory care, office-based surgery, and home care organizations; phase 2 for behavioral health care, laboratory, and long-term care accreditation programs began in 2008 and the standards changes will take effect in January 2010. Access the Standards Improvement Initiative web page.