Menu
Home / News & Resources / OHA Newsletters / By the Numbers

By the Numbers

A monthly compendium of OHA finance and patient financial services policy and payment alerts


Subscribe to By the Numbers                                                                           View Archive

 

OHA Group Secures ODM Agreement to Revisit Cuts; State Officials Still Can’t Explain Projected Shortfall

09/29/2017

A group of Ohio hospital leaders led by OHA Board Chair Kevin Webb (ProMedica) and Chair-elect Bruce White (Knox Community Hospital) met with Ohio Department of Medicaid actuaries and staff on Sept. 18 to press for the rationale behind $690 million in additional hospital cuts announced after the state budget was approved end of June Read More . . .

OHA Demands Anthem Rescind New Imaging Policies

09/29/2017

The Ohio Hospital Association, through legal counsel Bricker & Eckler LLP, has demanded Anthem rescind its adoption of a retroactive review process of the medical necessity of all MRIs and certain CT scans performed in hospital emergency departments and dually pending claims for clinical reviews billed with high-tech imagin Read More . . .

Transparency Lawsuit Hearing Delayed

09/29/2017

The Williams County Court of Common Pleas on Sept. 21 announced the preliminary injunction hearing regarding OHA’s challenge to the price transparency law is delayed from next week's scheduled dates of Sept. 26-27 until Dec. 20-21. The Court’s order also combines the preliminary injunction hearing with the permanent Read More . . .

OHA Comments on Proposed Medicare Hospital Payment System Changes for 2018

09/29/2017

OHA submitted comments Sept. 11 to the Centers for Medicare & Medicaid Services on the proposed rule to implement the Affordable Care Act’s Medicaid DSH reductions. In the letter, OHA requested CMS make changes to its proposals regarding alternative payment methodology for 340B pricing program, the inpatient-only list, re Read More . . .

CMS Extends Deadline for S-10 Reporting Changes to Oct. 31

09/29/2017

CMS notified OHA it has extended the window for hospitals to amend uncompensated care, bad debt and other Worksheet S-10 reporting on their fiscal year 2014 and 2015 Medicare cost reports from Sept. 30 to Oct. 31. Please remember proper reporting of data on Worksheet S-10 is critical, as it will drive the distribution of inpatient Read More . . .

Don’t Wait: Part A Direct Data Entry Recertification Due by Sept. 30

09/29/2017

Each year, Medicare providers are required to recertify their Direct Data Entry user access. The recertification period for Part A providers is now. The recertification process has changed. Failure to recertify will result in termination of your user ID and access to DDE.   What You Need to Do:    Complete the Ann Read More . . .

ODM Confirms 340B Hospital Outpatient Modifier Requirement for Oct. 1

09/29/2017

ODM’s section chief confirmed in a written statement on Sept. 27 to OHA that the department is moving forward with its 340B modifier requirement beginning Oct. 1. Hospitals recognized as a 340B entity are required to notify Medicaid agencies when a 340B purchased drug is provided to a Medicaid individual so that the Medicaid Read More . . .

Ohio Medicaid NDC Code Enforcement Takes Effect Jan. 1, 2018

09/29/2017

The Ohio Department of Medicaid announced its required National Drug Codes for all pharmacy line items on outpatient hospital Medicaid bills with an enforcement date of Jan. 1, 2018. ODM approved the new process in August 2016 with an effective date of Jan. 1, 2017, but then delayed the enforcement date until Jan. 1, 2018 Read More . . .

Reminder: New Outpatient Behavioral Health Service Codes Available

09/29/2017

Beginning Aug. 1 with implementation of Ohio Administrative Code rule 5160-2-75, hospitals that have secure accreditation (such as JCAHO) to provide outpatient behavioral health services to Medicaid-eligible individuals can bill to newly developed Outpatient Behavioral Health Services codes. ODM informed OHA on July 24 th Read More . . .

Medicaid FFS Billing: Omit Uncovered Charges

09/29/2017

OHA reminds member hospitals that when billing claims to Medicaid fee for service, providers need to omit non-covered charges, such as administration fees. ODM confirmed that billing any non-covered service on a claim will result in a non-covered denial for the date of service. While it is important to capture all charges that gro Read More . . .

Hospitals Report Success in Using ODM Provider Complaint Process

09/29/2017

Hospitals reported to OHA in July and again in September that the complaint communication process launched over the summer is yielding positive results in resolving claim and payment issues with the Medicaid managed care plans. OHA worked with the ODM’s Bureau of Managed Health Care to develop a user friendly provider co Read More . . .

Ohio CPC Extended into 2018

09/29/2017

ODM will extend Ohio Comprehensive Primary Care into 2018 and will offer another enrollment period for practices who meet the following criteria:   Practice with 5,000+ Medicaid members and national primary care or patient centered medical home accreditation including NCQA standards (established in 2017), NCQA II/III, URAC, J Read More . . .

Expect SIM Episode Payments/Withholds by Year End

09/29/2017

The state has posted Performance Year 2017 SIM episode reports to the MITS portal. These reports cover the 13 episodes from Wave 1 and Wave 2. Currently three of the Wave 1 episodes are tied to payments – asthma exacerbation, COPD exacerbation and perinatal. The performance year for these episodes closed at the end of 201 Read More . . .

OHA Issues Call for 2018 Annual Meeting Presentations

09/29/2017

The Ohio Hospital Association is seeking dynamic and engaging presentations to educate health care professionals and motivate the pursuit of excellence at the 2018 OHA Annual Meeting June 4-6 in Columbus. Representatives from member hospitals, OHA corporate partners and other health care-related organizations are invited to complete Read More . . .

Just the Facts - September 2017

09/29/2017

An archived copy of the Sept. 12 “FFY 2015 Ohio Medicaid DSH Audits Launch” webinar is available. OHA hosted the webinar with Myers & Stauffer and an archive copy of the webinar is available here. Download a copy of the PowerPoint here. A copy of the Patient Log Template workbook for 2015 DSH Examination is avai Read More . . .

Medicaid Managed Care Plans Provide Update on EAPG Implementation Delay Resolutions

09/29/2017

The Ohio Hospital Association continues to work with the Ohio Department of Medicaid and Ohio Medicaid’s managed care plans on their processing of Medicaid claims after the EAPG implementation struggled on Aug. 1.  The following processes for each plan have been updated to reflect where plan each is n processing and Read More . . .

OHA Summary Recaps State Budget Provision, Ohio Senate Overrides Health Care-Related Vetoes

08/31/2017

OHA’s Advocacy team has developed a summary of the health care and hospital-related budget provisions tracked throughout the state budget process. When Gov. John Kasich signed the budget June 28, he vetoed 47 items, including several elements related to Medicaid and health care. ​ The summary includes details on the veto ove Read More . . .

2018 Payment, Policy Updates for Medicare Admissions Finalized

08/31/2017

CMS on Aug. 2 issued the fiscal year 2018 Medicare Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System final rule. This updates 2018 Medicare payment and policies when patients are discharged from hospitals. CMS stated that the final rule relieves regulatory burdens for providers, supports the Read More . . .

OHA Comments on Proposed Medicaid DSH Reductions

08/31/2017

OHA on Aug. 28 submitted comments to Centers for Medicare & Medicaid Services on the proposed rule to implement the Affordable Care Act’s Medicaid DSH reductions. In the letter, OHA requested CMS change the proposed methodology to reduce the impact of DSH cuts on Ohio hospitals. As previously reported, based on the propos Read More . . .

CMS Cancels Episode, Cardiac Bundle Payment Models; Proposes Changes to Joint Replacement Model

08/31/2017

CMS on Aug. 15 said it will roll-back two bundled-payment models that were set to start on Jan. 1, 2018 — the Advancing Care Coordination through Episode Payment Models and Cardiac Rehabilitation Incentive Payment Models. CMS also announced it will scale back the number of mandatory geographic areas participating in the Compre Read More . . .

 |<  < 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10  >  >| 
Displaying results 1-20 (of 250)
© 2017 The Ohio Hospital Association. All Rights Reserved.