NAPHS comment letter on CMS proposed rule on quality reporting requirements for inpatient psychiatric facilities

CMS guidance to state survey agency directors: "Advanced Copy- Appendix Z, Emergency Preparedness Final Rule Interpretive Guidelines and Survey Procedures" (to start 11.15.17)

Mental Health Liaison Group letter in support of the Medicare Mental Health Inpatient Equity Act of 2017 (H.R.2509), which would repeal the Medicare 190-day lifetime limit for inpatient psychiatric care

Medicare Learning Matters article (MM9671): "Outlier Limitation on Outpatient Prospective Payment System (OPPS) Community Mental Health Centers (CMHC) Services"

Medicare Learning Matters article (MM9880): "Implementing the Remittance Advice Messaging for the 20 Hour Weekly Minimum for Partial Hospitalization Program Services."  Also see CMS Transmittal 1833.

CMS proposed rule on inpatient PPS for acute-care hospitals (including section on IPF Quality Reporting Program). See pages 20120-20127 on IPFQR. Also see CMS news release and fact sheet.

CMS: "Fact Sheet: Behavioral Health Integration Services" and "Frequently Asked Questions about Billing Medicare for Behavioral Health Integration Services" (Medicare fee-for-service physician fee schedule)

CMS final rule: "Medicare Program: Changes to the Medicare Claims and Entitlement, Medicare Advantage Organization Determination, and Medicare Prescription Drug Coverage Determination Appeals Procedures"

HHS/OIG final rule: “Health Care Programs: Fraud and Abuse; Revisions to the Office of Inspector General’s Exclusion Authorities”

Medicare Learning Matters article (MM9930): "January 2017 Update of the Hospital Outpatient Prospective Payment System (OPPS)"

CMS subregulatory guidance: "Extraordinary Circumstance Relocation Exception Guidance for an Off-Campus Provider-Based Department"

CMS preliminary guidance on Hospital Outpatient Department provisions in the 21st Century Cures Act

CMS Center for Clinical Standards and Quality/Survey & Certification Group: "Updated Guidance to Surveyors on Federal Requirements for Providing Services to Justice Involved Individuals"

NAPHS comment letter to CMS regarding OPPS final rule with comment period ("Medicare Program: Hospital Outpatient Prospective Payment...Systems and Quality Reporting Programs;...etc.").  Includes comments on 20-hour-per-week partial hospitalization requirement.

HHS Office of Inspector General (OIG) report: “Vulnerabilities Remain Under Medicare’s Two-Midnight Hospital Policy”

HHS/OIG final rule: "Medicare and State Health Care Programs: Fraud and Abuse; Revisions to the Safe Harbors Under the Anti-Kickback Statute and Civil Monetary Penalty Rules Regarding Beneficiary Inducements"

HHS/OIG final rule: "Medicare And State Health Care Programs: Fraud And Abuse; Revisions to the Office Of Inspector General's Civil Monetary Penalty Rules"

CMS final rule: "Medicare Program: Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY17..." (including Psychiatric Collaborative Care). Also see CMS news release and blog, 11.18.16 correction, and 12.29.16 correction.

CMS final rule with comment period: "Medicare Program: Hospital Outpatient Prospective Payment...Systems and Quality Reporting Programs;...etc." (NOTE: partial hospitalization section begins on p.79678). Also see CMS release and fact sheet.

CMS final rule with comment period: "Medicare Program: Merit-Based Incentive Payment System and Alternative Payment Model Incentive under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models" (required by MACRA)

CMS fact sheet: "Date Change & Phased Enforcement of Part D Prescriber Enrollment"

OIG report (A-07-15-01158): "Medicare Improperly Paid Providers Millions of Dollars for Incarcerated Beneficiaries Who Received Services During 2013 and 2014"

CMS provider webpage: "What does the Social Security Number Removal Initiative (SSNRI) mean for providers?"

Social Security Administration final rule: "Revised Medical Criteria for Evaluating Mental Disorders." Also 12.2.16 correction.

CMS final rule: "Medicare and Medicaid Programs; Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers."  Also see 11.16.16 corrections.

NAPHS comment letter to CMS on “Collaborative Care Model for Beneficiaries with Common Behavioral Health Conditions” (in proposed rule on CY17 physician fee schedule)

HHS/OIG/CMS interim final rule: "Adjustment of Civil Monetary Penalties for Inflation"

NAPHS comment letter on proposed rule on Hospital Outpatient Prospective Payment System (OPPS)

CMS final rule on inpatient PPS for acute-care hospitals (including sections on IPF Quality Reporting Program, observation status, and uncompensated care).  Also see 10.5.16 correction and 10.31.16 correction.

CMS "Clarifying Questions & Answers Related to the 7.6.15 CMS/AMA Joint Announcement and Guidance Regarding ICD-10 Flexibilities" (updated 8.18.16)

NAPHS comment letter to CMS on proposed rule on Hospital Conditions of Participation

Medicare Learning Network (MLN) Matters article (MM9732): “Update—Inpatient Psychiatric Facilities Payment System Fiscal Year 2017.”

CMS notice: "Medicare Program; FY 2017 Inpatient Psychiatric Facilities Prospective Payment System—Rate Update."  Also see 8.1.16 Medicare Network Learning (MLN) Matters article (MM9732).

CMS proposed rule: "Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY2017" (see pg.46201-46205 for sections on Collaborative Care Model for common behavioral health conditions). Also see 8.10.16 correction.

CMS proposed rule: "Medicare Program: Hospital Outpatient PPS and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs;....EHR Incentive Programs; Payment to Certain Off-Campus Outpatient Departments of a Provider; Hospital Value-Based Purchasing Program" (NOTE: partial hospitalization section begins on p.45667)

NAPHS testimony on the Medicare 190-day lifetime limit for Health Care Subcommittee of the Senate Finance Committee hearing on “Alzheimer’s Disease: The Struggle for Families, a Looming Crisis for Medicare”

CMS final rule: "Medicare Program: Expanding Uses of Medicare Data by Qualified Entities"

NAPHS Alert: "CMS suspends partial hospitalization code edits planned to start 7.1.16." See MLN Matters revision.

CMS proposed rule: "Changes to the Medicare Claims and Entitlement, Medicare Advantage Organization Determination, and Medicare Prescription Drug Coverage Determination Appeals Procedures"

NAPHS comment letter on CMS proposed rule on quality reporting requirements for inpatient psychiatric facilities (for FY17) 

CMS proposed rule: "Medicare & Medicaid: Hospital & Critical Access Hospital Changes to Promote Innovation, Flexibility, and Improvement in Patient Care" (proposed changes to Hospital CoPs)

CMS final rule: "Medicare Shared Savings Program; Accountable Care Organizations--Revised Benchmark Rebasing Methodology, Facilitating Transition to Performance-Based Risk, and Administrative Finality of Financial Calculations."

IMPORTANT UPDATE: CMS delays data-collection of 3 IPFQR measures (metabolic screening and 2 transition-of-care measures) until 1/1/17

Joint Commission announces it will begin surveying to the 2012 version of the National Fire Protection Association’s 101 Life Safety (LS) Code as of 7/5/16. Also see 5.4.16 CMS final rule.

NAPHS/AABH letter to CMS detailing concerns with “Enforcement of the Partial Hospitalization Program 20 Hours per Week Billing Requirement” (SE1607)

HHS final rule: "Nondiscrimination in Health Programs and Activities." Also see 7.18.16 correction.

Medicare Learning Matters article (MM9961): "July 2016 Integrated Outpatient Code Editor (I/OCE) Specifications Version 17.2” including planned partial hospitalization code edits

Medicare Learning Network Matters article (MM9522): "Clarification of Inpatient Psychiatric Facilities (IPF) Requirements for Certification, Recertification and Delayed/Lapsed Certification and Recertification"

CMS proposed rule: "Medicare Program: Merit-Based Incentive Payment System and Alternative Payment Model Incentive under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models"

CMS final rule: "Medicare and Medicaid Programs: Fire Safety Requirements for Certain Health Care Facilities." Also see 6.30.16 correction.

CMS Center for Clinical Standards and Quality/Survey & Certification Group "Guidance to Surveyors on Federal Requirements for Providing Services to Justice Involved Individuals"  (see 12.23.16 update)

MLN Matters® Special Edition Article (SE1604); "Medicare Coverage of Substance Abuse Services"

CMS proposed rule on quality reporting requirements for inpatient psychiatric facilities (for FY19 payment determination). See pages 25238-25244 on IPFQR.

Medicare Learning Matters Special Edition Article (SE1607): "Enforcement of the Partial Hospitalization Program (PHP) 20 Hours per Week Billing Requirement".  [Also see 7.7.16 suspension of July 1, 2016, implementation of code edits.]

CMS proposed rule: "Medicare, Medicaid, and Children’s Health Insurance Programs; Program Integrity Enhancements to the Provider Enrollment Process"

NAPHS letter to House Energy and Commerce Committee: "Partial hospitalization should be exempt from site-neutral provision"

CMS final rule: "Medicare Program; Reporting and Returning of Overpayments"

CMS proposed rule: "Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations -- Revised Benchmark Rebasing Methodology, Facilitating Transition to Performance-Based Risk, and Administrative Finality of Financial Calculations"

CMS proposed rule: "Medicare Program: Expanding Uses of Medicare Data by Qualified Entities"

NAPHS comment letter to CMS on "Medicare and Medicaid Programs; Revisions to Requirements for Discharge Planning for Hospitals, Critical Access Hospitals, and Home Health Agencies”

CMS final rule: "Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY2016" (see p.70919 for sections on Collaborative Care Models for common behavioral health conditions). Also see 3.8.16 corrections and 6.1.16 corrections.

CMS final rule on the Medicare outpatient prospective payment system/partial hospitalization program (OPPS/PHP) rates for CY16. 

CMS: "Recovery Audit Program Enhancements (status as of November 6, 2015)"

CMS: "Medicare Fee-for-Service Recovery Audit Program Additional Documentation Limits for Medicare providers (except suppliers and physicians)." Effective 1.1.16.

CMS proposed rule: "Medicare and Medicaid Programs; Revisions to Requirements for Discharge Planning for Hospitals, Critical Access Hospitals, and Home Health Agencies"

CMS final rule correction: "Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System—Update for Fiscal Year Beginning October 1, 2014 (FY 2015); Correction"

NAPHS comment letter on proposed Medicare hospital outpatient PPS/partial hospitalization program (OPPS/PHP) rates for CY16

CMS final rule: "Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System-Update for Fiscal Year Beginning October 1, 2015 (FY16)" (including IPF Quality Reporting measures) 

CMS proposed rule: "Medicare: Revisions to Payment Policies Under the Physician Fee Schedule & Other Revisions to Part B for CY16" (see p.41710 requesting comments on Collaborative Care Models for common behavioral health conditions)

CMS proposed rule on the Medicare hospital outpatient prospective payment system/partial hospitalization program (OPPS/PHP) rates for CY16

CMS letter to the field on transition to ICD-10. Also see 7.27.15 clarifications.

NAPHS comment letter to CMS on proposed rule: "Inpatient Psychiatric Facilities PPS-Update for Fiscal Year Beginning October 1, 2015 (FY16)" (including IPFQR quality measures)

CMS final rule: "Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations"

CMS final rule: "Medicare and Medicaid Programs: Revisions to Deeming Authority Survey, Certification,and Enforcement Procedures"

CMS proposed rule: "Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System-Update for Fiscal Year Beginning October 1, 2015 (FY16)." Also see CMS fact sheet.

America's Hospitals and Health Systems letter to the Senate in support of H.R.2 (the Medicare Access and CHIP Reauthorization Act of 2015), a bipartisan compromise to permanently resolve the SGR.

America's Hospitals and Health Systems letter to House in support of the Medicare Access and CHIP Reauthorization Act of 2015 (H.R.2), a bipartisan compromise to permanently resolve the Sustainable Growth Rate (SGR)

Revised Medicare Learning Network publication on "Mental Health Services" (ICN 903195)

Notice of CMS ruling (CMS-4176-R): "Implementing United States v. Windsor for Purposes of Entitlement and Enrollment in Medicare Hospital Insurance and Supplementary Medical Insurance" (implementing Supreme Court ruling on Defense of Marriage Act)

America's Hospitals and Health Systems letter: "Oppose any additional hospital Medicare and Medicaid cuts to offset the cost of resolving the SGR"

NAPHS release: "President’s FY16 Budget Tackles Lingering Discrimination; NAPHS Applauds Proposal to Eliminate the Medicare 190-Day Lifetime Limit, Urges Action to Address Discrimination in Medicaid"

CMS Transmittal 132: "New Additions to State Operating Manual (SOM), Psychiatric Residential Treatment Facilities (PRTF) Chapter 2"

CMS Transmittal 131: "New to State Operations Manual (SOM), Appendix N- Psychiatric Residential Treatment Facilities (PRTF) Interpretive Guidance"

CMS proposed rule: "Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations"

NAPHS comment letter to OIG on proposed rule on "Medicare and State Health Care Programs: Fraud and Abuse; Revisions to Safe Harbors Under the Anti-Kickback Statute, and Civil Monetary Penalty Rules Regarding Beneficiary Inducements and Gainsharing" (recommending transportation safe harbors)

NAPHS Action Alert: "New Resources Now Available for the IPFQR Program; Next Webinar is November 20, 2014 at 2pm Eastern"

CMS final rule: "Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule, Clinical Laboratory Fee Schedule, Access to Identifiable Data for the Center for Medicare and Medicaid Innovation Models & Other Revisions to Part B for CY2015."  Also see 12.31.14 corrections.

CMS final rule on the Medicare outpatient prospective payment system/partial hospitalization program (OPPS/PHP) rates for CY15. 

NAPHS Action Alert: October 29 Inpatient Psychiatric Facility Quality Reporting Program National Provider webinar on "A Closer Look at the Measures for Collection CY 2015" at 2pm Eastern. Download slides.

NAPHS comment letter on proposed Medicare hospital outpatient prospective payment system/partial hospitalization program (OPPS/PHP) rates for CY15.

CMS final rule:  "Medicare Program: Inpatient Psychiatric Facilities Prospective Payment System - Update for Fiscal Year Beginning October 1, 2014 (FY15).”

CMS final rule setting compliance deadline for converting to the ICD-10 system as October 1, 2015.

CMS proposed rule on the Medicare outpatient prospective payment system/partial hospitalization program (OPPS/PHP) rates for CY15 and OPPS quality measures.

OIG proposed rule: "Medicare and State Health Care Programs: Fraud and Abuse; Revisions to the Office of Inspector General’s Civil Monetary Penalty Rules"

CMS final rule: "Medicare and Medicaid Programs;Regulatory Provisions To Promote Program Efficiency, Transparency, and Burden Reduction; Part II" (includes medical staff revisions).

CMS proposed rule:  "Medicare Program: Inpatient Psychiatric Facilities Prospective Payment System - Update for Fiscal Year Beginning October 1, 2014 (FY15).” Also see CMS fact sheet.

CMS release: First public reporting of quality measures from inpatient psychiatric facilities launched on Hospital Compare

CMS proposed rule: "Medicare and Medicaid Programs: Fire Safety Requirements for Certain Health Care Facilities"

CMS MedLearn Matters: "Termination of the Common Working File ELGA, ELGH, HIQA, HIQH, and HUQA Part A Provider Queries (Revised MM 8248)"

NAPHS comment letter to CMS proposed rule on "Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers"

2014 Advocacy Priorities: 1) End discrimination (modify the Medicaid IMD exclusion); 2) Fix gaps (support H.R.3717); 3) Support Medicare/Medicaid funding for health information technology.

NAPHS comment letter on "Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs"

CMS: Recent updates on the Recovery Audit (RAC) Program. Also see 5 changes to the RAC in response to industry feedback.

Senate Finance Committee "Summary and Overview of Mental Health Recommendations" received in response to their 8.1.13 Open Letter seeking input on how to improve the US mental health system.

CMS proposed rule: "Medicare Program; Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs"

CMS proposed rule: “Medicare and Medicaid Programs; Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers”. (Comment deadline extended to 3.31.14)

MedPAC/MACPAC data book: Beneficiaries Dually Eligible for Medicare and Medicaid (with demographic, expenditure, and healthcare utilization information)

CMS final rule on Medicare Hospital Outpatient Prospective Payment System (including CY14 partial hospitalization rates).  See pages 75045-75054.

Order a recording of a special training call on "Reporting SUB-1 (Alcohol Use Screening) in the IPFQR." Also download materials (files are large; please allow time for each to open): 1) Joint Commission PowerPoint; 2) Michael Miller, M.D., PowerPoint; 3) Eric Goplerud PowerPoint; 4) SBIRT Mentor brochure. Also see 5) the Telligen IPFQR newsletter. After the training, please complete 6) an online evaluation.

Updated FAQs on "Medicare 2013 Claim Denials Due to Beneficiary Incarceration Status"

CMS: Inpatient Psychiatric Facility Quality Reporting (IPFQR) Quarterly Newsletter (Vol.1.No.1)

CMS final rule: "Medicare Program: Conditions of Participation (CoPs) for Community Mental Health Centers"

Mental Health Liaison Group (MHLG) comment letter responding to Senate Finance Committee open letter seeking input on how to improve the US mental health system

NAPHS comment letter responding to Senate Finance Committee open letter seeking input on how to improve the US mental health system

AMA letter to CMS: On Incarcerated Beneficiary Claim Denial

NAPHS comment letter on proposed Medicare hospital outpatient prospective payment system/partial hospitalization program (OPPS/PHP) rates for CY14

CMS final rules: "Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals...and FY2014 Rates; Quality Reporting Requirements for Specific Providers; ....etc."  (See pages 50887-50901 for IPF quality reporting section.)  Also see 7.30.14 correcting amendment.

CMS extends the IPFQR Notice of Participation submission deadline to August 23, 2013

CMS Notice: "Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System - Update for Fiscal Year Beginning October 1, 2013 (FY 2014)." 

OIG report: "Hospitals' Use of Observation Stays and Short Inpatient Stays for Medicare Beneficiaries"

CMS proposed rule on the Medicare outpatient prospective payment system/partial hospitalization program (OPPS/PHP) rates for CY14. Also see 9.6.13 correction.

NAPHS comment letter to CMS: "Medicare: ....Quality Reporting Requirements for Specific Providers (CMS-1599-P)"

CMCS-MMCO-CM Informational Bulletin:  "Payment of Medicare Cost Sharing for Qualified Medicare Beneficiaries (QMBs)." Tells states that they “have a legal obligation to reimburse providers for any Medicare cost sharing due for QMBs according to the state’s CMS-approved Medicare cost-sharing payment methodology.” 

CMS final rule: "Medicare: Medical Loss Ratio Requirements for the Medicare Advantage and the Medicare Prescription Drug Benefit Programs."  Also see 7.22.13 correction.

NAPHS releases first study to examine readmissions within the Medicare Inpatient Psychiatric Facility Prospective Payment System (IPF PPS). View news release and study.

OIG guidance: "Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs."  Also see 5/9/13 Federal Register.

Joint statement from NAMI and NAPHS on the Medicare 190-day lifetime limit. Presented to the House Ways & Means Health Subcommittee hearing "Examining Traditional Medicare's Benefit Design."

NAPHS comment letter to OIG on "Solicitation of New Safe Harbors and Special Fraud Alerts"

OIG Report: "Vulnerabilities in CMS's and Contractors' Activities To Detect and Deter Fraud in Community Mental Health Centers" (OEI-04-11-00101) 

CMS final rule with comment period: "CMS-1589-FC: Medicare: Hospital Outpatient Prospective Payment System..." (including CY13 partial hospitalization rates, pages 68404-68418).

NAPHS Action Alert: Tell Congress to support behavioral health as fiscal cliff solutions are discussed

CMS final rule setting compliance deadline for converting to the ICD-10 system as October 1, 2014.  Also see 10.4.12 corrections. 

NAPHS comment letter on proposed Medicare hospital outpatient prospective payment system/partial hospitalization program (OPPS/PHP) rates for CY13 [View]

OIG report on "Questionable Billing by Community Mental Health Centers" [View]

CMS notice: "Medicare Program: Inpatient Psychiatric Prospective Payment System; Update for Fiscal Year Beginning October 1, 2012" [View]

Mental Health Liaison Group (MHLG) ad on demonstration programs for dual-eligibles (as seen in Politico): "Living with mental and addictive disorders is hard enough...don't make it worse for us" [View]

Mental Health Liaison Group (MHLG) release: "Mental health groups raise concerns about the current structure of dual-eligible demonstrations." Also see a MHLG letter to the Senate Special Committee on Aging

NAPHS comment letter to CMS on psychiatric inpatient quality reporting measures [View]

Mental Health Liaison Group letter to CMS on concerns related to dual-eligible demonstrations as they impact individuals with mental illness [View]

MedPAC chapter (Section 6) on specialty inpatient psychiatric facilities (from A Data Book: Health Care Spending and the Medicare Program) [View]

MedPAC Chapter 3 on dual eligibles (from A Data Book: Health care spending and the Medicare Program)

Kaiser Commission on Medicaid & the Uninsured: "Geographic Variation in Dual-Eligible Enrollment" (by state) [View]

CMS final decisions on the recommendations of the Hospital Outpatient Payment Panel on supervision levels for select services (also see 5/18/12 NAPHS comment letter) [View]

CMS final rule: "Medicare and Medicaid Programs: Reform of Hospital and Critical Access Hospital Conditions of Participation" [View]

CMS final rule: "Medicare and Medicaid Programs: Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction" [View]

CMS proposed rule on psychiatric inpatient quality reporting measures. See pages 28105-28116 in "Medicare Program: Hospital Inpatient PPS for Acute Care Hospitals and Long-Term Care Hospital PPS and FY13 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory Surgical Centers" [View]

CMS final rule: "Medicare & Medicaid: Changes in Provider and Supplier Enrollment, Ordering and Referring, and Documentation Requirements; and Changes in Provider Agreements" (including use of NPI) [View]

NAPHS comment letter and position paper on dual-eligible demonstrations sent to CMS Medicare-Medicaid Coordination Office (in response to request for feedback on Massachusetts dual-eligible demonstration). [NOTE: Check periodically online to view additional state demonstrations as they become available for comment.]

NAPHS comment letter to HHS OIG on "Solicitation of New Safe Harbors and Special Fraud Alerts" with recommendations on complimentary transportation [View]

CMS proposed rule: "Medicare Program: Reporting and Returning of Overpayments." Also see 2/14/12 CMS release: "Affordable Care Act Gives CMS New Authority To Recover Overpayments From Providers and Suppliers More Quickly"

HHS interim final rule: "Administrative Simplification: Adoption of Standards for Health Care Electronic Funds Transfer (EFTs) and Remittance Advice" [View]

MedLearn Matters article (MM7672): January 2012 Update of the Hospital Outpatient Prospective Payment System [View]

NAPHS comment letter to CMS on proposed rule on "Reform of Hospital and Critical Access Hospital Conditions of Participation" [View]

Medicare Learning Network Fact Sheet: "Substance (other than tobacco) abuse structured assessment and brief intervention (SBIRT) services" [View]

Robert Wood Johnson Foundation: Report on "Refocusing Responsibility for Dual Eligibles: Why Medicare Should Take the Lead"

OIG Report (OEI-01-08-00590): "Adverse Events in Hospitals: Medicare's Responses to Alleged Serious Events" [View]

NAPHS statement on introduction of H.R.2783, the Medicare Mental Health Inpatient Equity Act (to eliminate 190-day lifetime limit). Also see Mental Health Liaison Group letter of support for H.R.2783 (56 organizations).

NAPHS comment letter to CMS on proposed rule on Conditions of Participation for community mental health centers (CMHCs)

Final rule: "Medicare Program: Inpatient Rehab Facility PPS for Federal FY12; Changes in Size and Square Footage of Inpatient Rehabilitation Units and Inpatient Psychiatric Units" [View]

NAPHS comment letter: "Medicare and Medicaid Programs: Opportunities for Alignment Under Medicaid and Medicare" [View]

NAPHS comment letter to CMS on proposed rule: "Medicare and Medicaid Programs: Influenza Vaccination Standard for Certain Participating Providers and Suppliers" [View]

Final rule: Medicare & Medicaid: Changes Affecting Hospital and Critical Access Hospital Conditions of Participation: Telemedicine Credentialing and Privileging [View]

Proposed rule: Medicare program: Changes in size and square footage of inpatient rehab units and inpatient psychiatric units (see p. 24251-2) [View]

NAPHS statement on introduction of S.374, the Medicare Mental Health Inpatient Equity Act [View]

MedLearn Matters article (MM7072): Implementation of Edits for the Emergency Department Adjustment Policy under the Inpatient Psychiatric Facility Prospective Payment System [View]

Federal Register: Final rule: "Medicare and Medicaid Programs: Changes to the Hospital and Critical Access Hospital Conditions of Participation to Ensure Visitation Rights for All Patients" [View]

NAPHS statement: On introduction of H.R.6143, the Medicare Mental Health Inpatient Equity Act (to eliminiate the 190-day lifetime limit) [View]

MedLearn Matters: Implementation of the Interrupted Stay Policy Under the Inpatient Psychiatric Facility Prospective Payment Systems (IPF PPS) -- (CR)#: 7044 [View]

CMS MedLearn Matters (SE1024): "RAC Demonstration High-Risk Vulnerabilities: No Documentation or Insufficient Documentation Submitted" [View]

MedLearn Matters Special Edition Article (SE1020): "Reminder to Inpatient Psychiatric Facilities to Use Source of Admission Code D for Patient Transfers within the Same Facility" [View]

CMS clarifies outpatient supervision policy (Transmittal 128) [View]

OIG "Nationwide Review of Medicare Part A Emergency Department Adjustments for Inpatient Psychiatric Facilities During Calendar Years 2006 and 2007" (A-01-09-00504) [View]

OIG "Nationwide Review of Medicare Payments for Interrupted Stays at Inpatient Psychiatric Facilities for CYs 06 and 07" (A-01-09-00508) [View]

CMS announces limits on the number of medical records that may be requested by recovery audit contractors [View]

CMS on "Preparing for a Transition from an FI/Carrier to a Medicare Administrative Contractor (MAC)" [View]

CMS email on 8 "Frequently Asked Questions" (FAQs) on Medicare billing/payment policy on psychological and neuropsychological tests billed under the CPT code range 96101-96125 when performed by technicians, computers, physicians, clinical psychologists, independently practicing psychologists, and other eligible qualified nonphysician practitioners. The FAQs also address situations where more than one of these testing codes can be billed for services furnished to the same patient. [View]

OIG Open Letter to Health Care Providers refining the requirements of the OIG Provider Self-Disclosure Protocol under which healthcare providers can voluntarily report fraudulent conduct affecting Medicare, Medicaid, and other Federal healthcare programs.

NAPHS letter to CMS regarding initial surveys for new Medicare providers [View]

"Hospital Conditions of Participation: Requirements for History and Physical Examinations; Authentication of Verbal Orders; Securing Medications; and Postanesthesia Evalutions (CMS-3122-F)."

CMS email on "Admissions to an IPF" (Are substance abuse treatment services covered in an IPF?) [View]

CMS changes its online links to information about inpatient psychiatric PPS. Update your "favorites" or bookmarks to go to http://www.cms.gov/InpatientPsychFacilPPS/01_overview.asp for links to information about the IPPPS. [View]

The FINAL RULE on Medicare's move to an inpatient psychiatric prospective payment system is in the November 15, 2004, Federal Register. [View]

RECURRING:  CMS Web site on RACs (Recovery Audit Programs).