August 15, 2016 Legislation



CMS is penalizing hospitals for their incorrect coding of inpatient care.  The CMS dismayed the hospitals with doubling the amount to be withheld this year from 0.8% to 1.5%.  They are withholding the larger payment to get the full recoupment by 2017.  The hospitals should not cry too much since they will be getting more in 2017 than in 2016 due to a reversal of the 0.2% payment reduction under the two midnight rule and a one time increase to off set the two midnight rule.  However, long term care hospital will see a reduction of 7.1% in 2017 due to the site neutral policy for off site campuses.

A new law has gone into effect.  This one requires hospitals to notify patients if they have been in observation status for over 24 hours and not admitted to the hospital.  This will mean about 1.5 million notices per year.  The notice will also say that in order to receive nursing home coverage under Medicare the patient must be hospitalized for more than three days.  

Medicare is proposing mandatory bundled payment models for the new proposed geographic cardiac and ortho models.  In the past these have been voluntary.  The medical societies have been vocal in their dismay with the mandatory part of the program.  The physicians have won a victory with the mandatory programs being made into MIPS in the MACRA vernacular.  This means the physicians can make extra money with less hassle.

The administration is set to take away the restrictions on marijuana research.  This means that more than the University of Mississippi can now do research legally on the drug.  The researchers will need permission from the usual federal agencies to do the studies.  The drug is still on a list of highly addictive drugs without medical value.          Top


DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.