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In light of the significant number of changes to the revised ABN (including the related revisions to Chapter 30, Section 50 of the Medicare Claims Processing Manual) and the potential consequences for failure to provide advance notification when limitation on liability applies, healthcare providers are encouraged to do the following:
- Form a cross-disciplinary team with related responsibilities to transition to the revised ABN
- Review the revised ABN form
- Review the ABN FAQs and Form Instructions, as well as the revised provisions in Chapter 30, Section 50 in the Medicare Claims Processing Manual
- Review the existing Forms ABN-G and ABN-L, as well as the current ABN notification process
- Identify any outstanding questions that require clarification before proceeding
- Identify key changes that need to be implemented in order to be able to transition to the revised ABN by March 1, 2009
- Create a transition action plan, with timetables and accountability by departments/key individuals
- Implement the action plan, with ongoing monitoring and evaluation to determine whether target dates and plan objectives are being met
Editor’s note: Judith L. Kares, JD, CPC, authored this submission. She is an instructor for HCPro’s Medicare Boot Camp – Hospital Version. She is a lawyer and consultant who provides legal services and related healthcare compliance services to a wide variety of clients, including hospitals, health systems, HMOs, third party payers, physician practices and other healthcare entities. Visit www.hcprobootcamps.com to learn more.
On December 2, the OIG released the fiscal year (FY) 2007 annual report for the Health Care Fraud and Abuse Control Program, a joint effort of the Attorney General and the OIG.
Health insurance companies for Medicare received $1.3 billion more than projected in 2006, congressional auditors told the Associated Press.
The Government Accountability Office said in a report that if projections had been more accurate, much of that $1.3 billion could have gone to better benefits and lower premiums.
Read the Associated Press report.
See what hospital officials in California, Nevada and Hawaii are concerned about regarding reimbursement from Medicare in a report in The Mercury News.
CMS has released a MLN Matters article related to changes in the deductible, coinsurance and premium rates for 2009.
To view the article, click here.
On November 7, the OIG issued a report on disproportionate share hospital (DSH) capital payments for the period October 1, 2000, through September 30, 2006. The OIG found that a number of rural hospitals and hospitals with fewer than 100 beds claimed DSH capital payments during this period, even though those facilities were, according to federal requirements, ineligible for these payments.
To read the report, click here.
President-elect Barack Obama has selected former Senator Tom Daschle to head the Health and Human Services Department, a move many say is the first step toward a universal healthcare model for Americans, according to a Novermber 20 article in the Wall Street Journal.
In addition, Montana Senator Max Baucus, chairman of the finance committee, which oversees taxes and about 50% of government spending, released a healthcare model similar to that proposed by Obama during his presidential campaign.
To read the story in the Wall Street Journal, click here.
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