The National Association for Medical Direction of Respiratory Care

The Washington Watchline

The Proposed 2020 Medicare Payment for Hospital Services

On April 23, 2019, the Centers for Medicare & Medicaid Services (CMS) released the proposed Inpatient Prospective Payment System (IPPS) rule for 2020. CMS has indicated that its goal for 2020 is to transform the healthcare delivery system by implementing regulations that promote competition and innovation. Policies proposed in this rule focus on “rethinking rural health” and “unleashing innovation.” Efforts to address rural health care include proposals to increase the wage index of low wage index hospitals.

CMS Adds “Non-invasive Ventilators” to Competitive Bidding

Mechanical ventilation in the home has long been an area of interest and advocacy for The National Association for Medical Direction of Respiratory Care or NAMDRC. We have recently learned that The Centers for Medicare and Medicaid Services (CMS) intends to shift “non-invasive” home ventilators, from the frequent and substantial servicing category to the Competitive Bidding Program for durable medical equipment (DME).

NAMDRC 2019 Annual Meeting: Advancing the Care of the Critically Ill

The Annual Meeting and Educational Conference of the National Association for Medical Direction of Respiratory Care was held March 14th through 16th at the Sonoma Mission Inn in Sonoma, California. This meeting continued the well established tradition of combining evolving science with experienced clinical perspective. The program was developed around the NAMDRC core principles of improving the quality of patient care, reducing barriers to that care and anticipating changes in our practice environment.

CMS is Developing a Readmission Quality Metric for Physicians

For several years many Medicare participating hospitals have been penalized for certain unplanned readmissions within 30 days of discharge. The Medicare Central Office and several policy makers consider this program a great success. Accordingly, the Centers for Medicare and Medicaid (CMS) is in the preliminary stages of discussions about adopting a policy that would link physician and physician group payments to the numbers of their patients who have unplanned hospital readmissions; the Clinician and Clinician Group Hospital-wide All-cause Unplanned Readmission (HWR) Measure.

The HHS Office of Inspector General is Auditing Critical Care Services

In 2019, The Office of Inspector General (OIG) of Health and Human Services, will be continuing its efforts to identify errors in provider billing in the Medicare program. The great majority of the OIG’s work is focused on Medicare and Medicaid programs with roughly three quarters of its total funding committed to these two programs. This year, critical care services billed to Medicare, American Medical Association Current Procedural Terminology (AMA CPT) codes 99291 and 99292, will be audited by the OIG.

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