Diagnosis-related group coding determines eligibility for many Medicare bundled payment initiatives. This approach excluded many patients with chronic obstructive pulmonary disease likely to benefit ...
Hospital groups claim acute-care hospitals will lose billions of dollars under the CMS' proposal to introduce an expanded system for evaluating patient severity. The CMS in its fiscal 2008 proposed ...
A key objective is to enable updates to the MS-DRG payment rates that are no longer dependent on gross charges billed by hospitals that are reduced to cost using hospitals' cost report data. Included ...
Effective Date: This Final rule is effective June 20, 2014. Applicability Date: This rule applies to claims with a discharge date of October 1, 2014, or later from hospitals paid by TRICARE under the ...
A recent HHS Office of Inspector General (OIG) report examines Medicare services provided during the Medicare Severity Diagnosis Related Group (DRG) payment window – that is, the period when certain ...
Diagnostic-related groups (DRGs) are how Medicare and some other health insurance companies categorize hospital costs to determine how much to pay for a hospital stay. With DRGs, the payment amount ...
EDITOR’S NOTE: This story is part of the 2010 Health Care Benefits Guide, which can be found by clicking here. When lying in a hospital bed, a patient probably isn’t thinking much about how health ...
As we reported in our Managed Care Newsletter in April 2020, the CARES Act passed by Congress last year provides for a 20% increase to the DRG weights in the Medicare Inpatient Prospective Payment ...
You may be neck-deep in an EHR implementation in hopes of scoring American Recovery and Reinvestment Act incentive payments, but don't forget about the coming transition to ICD-10 coding. "To put it ...
Beginning in July, the agency that administers Florida’s managed care Medicaid program announced it plans to implement diagnosis-related group payments for hospital stays. The state’s current program ...
In the early stages of the DRG-based payment system, the approach of pricing claims based on the date of the beneficiary's admission to the hospital was an effective operational policy for TRICARE. It ...