Current Developments

Click on the dates below to view PDF versions of past issues of the monthly Current Developments newsletter.

• The December 2008 issue includes:
  • Revisions to the instructions for Form CMS-2552-96, Hospital and Health Care Complex Cost Report
  • Transmittal 418, which sets out the conditions for the exception to the three-year moratorium on new long-term care hospitals or increase in the number of LTCH beds
  • Updated list of CARCs and RARCs
  • New national coverage determinations
  • Furnishing fees for the clotting factor and the original site facility fee for telehealth services
  • Changes to the laboratory NCD edit module
  • Notice of collection of overpayments from home health agencies
    Plus
  • Article on recent revisions to Medical Records and Utilization Review Conditions of Participation and
  • The List of CMS Transmittals, effective in December 2008 and January 2009
• The November 2008 issue includes:
  • A summary of the 2009 Outpatient Prospective Payment System final rule
  • New J code for hemophilia patients with delayed submission
  • New ASC payment indicators
  • New C code for implanted prosthetic devices where patient has no Part A coverage
  • MIPPA revisions to the initial preventative physical examination
  • Clarification for billing assistants-at-surgery in a Method II CAH
  • Revised Medicaid definition of outpatient services
  • A MLN special edition article on how to transition from an FI/carrier to an A/B MAC
  • Plus a special article on IRF compliance with the Medicare transfer policy

• The October 2008 issue includes:
  • CMS Press Release Regarding Increased Fraud and Abuse Efforts
  • Announcement of the National RACs and Implementation Plans
  • Publication of the Medically Unlikely Edits
  • Summary of the October OPPS and ASC Updates
  • Release of OIG Supplemental Compliance Guidance for Nursing Facilities
  • Notice of Claims Hold for DRG 999 due to HAC logic problems
  • Transmittal Summarizing the Payment and Policy Changes for the IPPS and the IPF PPS
  • A Table of the FY 2009 Medicare Premiums, Co-Pays, and Deductibles
  • And a special article, “Hospitals, Contractors and Data Mining… What’s Next?”

• The September 2008 issue includes:
  • A summary of the I/OCE that becomes operational Oct. 6
  • Notice of an update to the Financial Management manual with the new Medicare process for recouping overpayments
  • Billing and claims processing information on the new NCD on artificial hearts
  • Notice of an extension of the hold on OPPS claims with code Q0091 (pap smear screening)
  • Results of a Trailblazer audit on problems reporting unlisted CPT codes
  • Quarterly table on CMS actions that will be implemented Oct. 6, 2008

• The August 2008 issue includes:
  • A summary of the final Inpatient Prospective Payment System rule for FY 2009
  • CMS’ announcement regarding adoption of ICD-10
  • A comparison of claims review processes used by different contractors
  • CMS’ explanation of the importance of correct completion of the Medicare cost reports
  • Announcement of the QIOs for the 9th Scope of Work
    
    
• The July 2008 issue includes summaries of:
  • the proposed Outpatient Prospective Payment System rule for 2009
  • the final report from CMS on the Recovery Audit Contractor pilot
  • the most recent CERT report
  • the OIG's letter to providers regarding the impact of MIPPA on their liability
  • the CMS plan for medical review of inpatient claims now that the QIOs no longer carry that responsibility
  • and other transmittals relevant to billing compliance issued in July
    
    
• June 2008
• May 2008