2020 Final Rule changes to Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Centers (ASC)
The ambulatory surgery center (ASC) payment system continues to evolve with the proposed changes to the hospital payment system (OPPS) for calendar year 2020. Fnd out what changes are proposed for implementation on January 1, 2020 for ASCs and hospital outpatient services in the CY2020 final rule. Physician practice managers will want to keep a close watch on the ASC and OPPS developments as more services migrate from one setting to another. Prepare your organization now for the proposed changes.
- Latest update on CMS' pricing transparency initiatives
- 2020 OPPS changes to drugs, biological, and radiopharmaceuticals
- 2020 340B drug rules
- 2020 changes to OPPS for cancer hospitals and partial hospitalization services
- 2020 changes to OPPS packaging
- 2020 methods to control outpatient volume increases related to clinic visits
- 2020 changes for ASCs
- 2020 changes to hospital outpatient and ASC quality requirements
- Additional changes to other policy areas such as prior authorizations and laboratory date of service rules
Mgd Care: Essentials of Medicare and Medicaid Managed Care
This course provides a brief history and overview of Medicare and Medicaid. It describes government organizations that regulate and administer this program. This course also discusses Medicare reimbursement. In addition, it highlights recent changes in the law affecting Medicare managed care contracting. This course also identifies the rights and responsibilities of Medicare enrollees. It also provides an overview of the Medicare Part D pharmacy benefit and points out some successes and failures of Medicaid managed care.
Proposed Changes to the Physician Self-Referral (Stark) Law to Promote Value-Based Payments
Certified Specialist Managed Care Recertification
The CSMC recertification program is recommended for active, eligible, HFMA CSPPM certificants with an upcoming maintenance due date of May 31, 2020. Not sure when your CSMC expiration date is? Sign in, click your profile image in the upper right corner, select My Development, and then click on the Certifications tab near the center of your page. You'll see your certifications along with their expiration date.
HFMA requires that eligible CSMC certificants gain continuing competence in the managed care arena by taking a short assessment every two years. This program provides healthcare organizations with a means to ensure that their staff has the body of knowledge necessary to meet their demands.
CSMC recertification course outline:
- Healthcare Delivery Systems
- Managed Care Reimbursement Methodologies
- Managed Care: Incentives, Emerging Trends, and Risks
- Provider and Payer Infrastructure and Process
- Essentials of Medicare and Medicaid Managed Care
This online program includes the above recertification courses and a recertification assessment. The assessment has 50 multiple choice questions and you have 90 minutes to complete it in one sitting. The passing score is 70%. If you do not pass on the first attempt, there is a mandatory 30-day waiting period. Please keep this in mind, as the deadline to complete the recertification assessment (to maintain your certification) is May 31, 2020.