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

 

Federal Disproportionate Share Hospital Audit Released May 14

05/31/2018

The results for the 2015 Federal Disproportionate Share Hospital Audit conducted by Myers & Stauffer for the Ohio Department of Medicaid began being released May 14. Hospitals that Myers & Stauffer determined to be in a recoupment status will be released first. Hospitals in recoupment status have 10 days to contact Myers &a Read More . . .

Verma Draws the Line on Medicaid Limits

05/31/2018

CMS Administrator Seema Verma on May 7 offered hospital executives good and bad news on Medicaid coverage limits and accountable care organizations' risk contracts during her presentation to the American Hospital Association annual meeting. CMS will reject Kansas' request to impose lifetime limits on Medicaid coverage, Read More . . .

OHA Works with ODM to Improve Communications Through Medicaid Managed Care Contracts

05/31/2018

The Ohio Hospital Association, through the Admitting, Billing & Collection Committee, last month was able to get new language added to future Ohio Department of Medicaid Managed Care Plan Provider Agreements. The new language: “The MCP is required to give a 30-calendar day advanced notice to providers of any new edits Read More . . .

CareSource Provides Operational Updates to OHA

05/31/2018

CareSource leadership on May 14 provided updates on a comprehensive list of outstanding issues OHA has been working for more than a year to resolve on behalf of member hospitals with Ohio’s largest Medicaid managed care payer. The core issues include claim processing breakdowns, covered service discrepancies, inappropriate den Read More . . .

Director Sears Provides Behavioral Health Redesign Update

05/31/2018

Barbara Sears, director, Ohio Department of Medicaid, on May 7 discussed the status of Behavioral Health Redesign with the Joint Medicaid Oversight Committee. You can view her presentation here. Read More . . .

ODM Reports Issues with Medicare/Medicaid Secondary Claims Processing

05/31/2018

The Ohio Department of Medicaid reports that some Medicaid secondary claims experienced processing issue during the month of April. The processing issue providers may see is that the Medicare paid amount is zero and the payment went to the deductible instead of paying Med Max. ODM advised that providers may adjust their claims, howe Read More . . .

KEPRO Launches Quarterly KEPRO Connect Ohio Newsletter

05/31/2018

The Ohio Department of Medicaid’s program integrity quality contractor, KEPRO, launched its first quarterly Ohio newsletter this week. The first KEPRO Connect Ohio newsletter focuses on substance use disorder prior authorization tips, hospital retrospective review recommendations and how to appeal a retrospective review denial Read More . . .

Anthem Announces New Commercial Facility Reimbursement Policy

05/31/2018

Anthem Blue Cross Blue Shield announced its new policy for Ohio, Indiana, Kentucky and Missouri that will become effective Aug. 1. The policy details the health plan’s guidelines for claims requiring additional documentation and the facility’s compliance for the provision of requested documentation. In addition to the r Read More . . .

OHA Releases Brief on CMS Proposed FY 2019 Inpatient Prospective Payment System Payment Rule

05/31/2018

The Centers for Medicare & Medicaid Services released its FFY 2019 Inpatient Prospective Payment System (IPPS) proposed payment rule. While OHA is working with our consultant on an in-depth analysis, a few key points and issues have already emerged in our review.  The proposed rule reflects the annual updates to the M Read More . . .

OHA Releases Brief on CMS Proposed FY 2019 IRF Prospective Payment System Rule

05/31/2018

CMS on May 8 published its Proposed Fiscal Year 2019 Medicare Inpatient Rehabilitation Facility Prospective Payment System, or IRF, Rule Update. The rule proposes to increase the IRF Standard Conversion Factor 1.15 percent.OHA’s Payment Rule Brief can be found at the link here. Please contact Shawn Stack with any questions. Read More . . .

OHA Releases Brief on CMS Proposed FY 2019 Inpatient Psychiatric Facility Prospective Payment System Rule

05/31/2018

CMS on May 8 issued its Proposed Fiscal Year 2019 Medicare Inpatient Psychiatric Facility Prospective Payment System, or IPF, Rule update. The rule proposes to increase inpatient IPF payment rates by a combined 1.4 percent. OHA’s Payment Rule Brief can be found at the link here. Please contact Shawn Stack with any quest Read More . . .

CGS Administrators, LLC Launches MBI Look-Up Tool

05/31/2018

New Medicare cards are being sent to beneficiaries through April 2019, and a substantial transition period will be in place from through Dec. 31, 2019 for providers to use either the Health Insurance Claim Number, or HICN, or the new Medicare Beneficiary Identifier for all Medicare transactions. Providers can use the myCGS MBI Read More . . .

CMS Summer Webinar Series Starts June 6

05/31/2018

Join the Centers for Medicare & Medicaid Services Chicago Regional Office webinar series beginning June 6. This new series includes webinars on the Quality Payment Program, new Medicare card project and Medicare provider enrollment process. Each webinar includes a question and answer session.Quality Payment Progra Read More . . .

Hold the Dates - May 2018

05/31/2018

Still time to register for the OHA Annual Meeting & Education Summit to be held June 4-6. Join members of the Ohio hospital community June 4-6 in Columbus for the 103rd Annual Meeting and Education Summit. The three-day event features more than 80 education sessions, keynote presentations by national leaders and special recognit Read More . . .

Just the Facts - May 2018

05/31/2018

Archive Copy: May 8 OHA Webinar on ODM Retrospective Claims Review OHA and KEPRO hosted a webinar May 8 10, "KEPRO: ODM Retrospective Claims Review" An archive copy of the webinar is available here. A copy of the ODM PowerPoint presentation for the session is available here.   The Ohio Bureau of Workers&rs Read More . . .

CMS Releases FY 2019 IPPS Proposed Rule

04/30/2018

The Centers for Medicare & Medicaid Services on April 24 issued its Proposed Fiscal Year 2019 Medicare Inpatient Prospective Payment System, or IPPS, Rule update. The rule proposes to increase inpatient operating rates by 1.75 percent and continue to push many of the administration’s health care promises such as reduction Read More . . .

CMS Proposes FY 2019 Rule for Inpatient Psychiatric Facility PPS

04/30/2018

The Centers for Medicare & Medicaid Services on May 27 issued its proposed rule to update payment rates for inpatient psychiatric facilities for fiscal year 2019. CMS proposes a net payment increase of 0.98 percent over payments in FY 2018. This includes a 2.8 percent market-basket update, minus 0.8 percent for productivity and Read More . . .

CMS Releases the Proposed FY 2019 Rule for Inpatient Rehabilitation Facilities, Skilled Nursing Facilities, Hospice

04/30/2018

The Centers for Medicare & Medicaid Services issued its FY2019 proposed IRF rule to update payment rates for inpatient rehabilitation facilities. CMS proposes a net payment increase of 0.9 percent over payments in FY 2018. The overall update to the payment rate includes a 2.9 percent market-basket update, minus 0.8 per Read More . . .

OHA Partners with Stakeholders to Address Behavioral Health Parity

04/30/2018

Parity@10 is a three-year campaign to establish effective models for robust enforcement of the Mental Health Parity and Addiction Equity Act in 10 states, including Ohio, and to disseminate those models across the country. The campaign’s goal is to ensure insurance carriers and state Medicaid programs offer fully parity c Read More . . .

Ohio Medicaid Delays Effective Date of Proposed Recalibration, Continues Dialogue with OHA

04/30/2018

The Ohio Department of Medicaid last month announced a proposal to recalibrate Medicaid relative weights (both APR-DRG and EAPG). ODM shared a fiscal analysis of the recalibration, which indicated this would reduce hospital payments by $84.4 million per year using 100 percent of fee-for-service pricing, and OHA hosted a March 2 Read More . . .

 |<  < 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10  >  >| 
Displaying results 1-20 (of 361)
© 2018 The Ohio Hospital Association. All Rights Reserved.