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Finance News

The latest news and updates on federal and state hospital and health system reimbursement policies and procedures.

View OHA's monthly finance alert wrap up - By the Numbers
 

Providers: Prepare for Ohioans with New Medicare Cards

06/14/2018

Ohioans covered by Medicare should begin receiving their new Medicare cards beginning the end of June. New Medicare cards are being sent out nationwide through April 2019 to replace existing Health Insurance Claim Numbers, or HICNs. There is a 21-month transition period where providers will be able to use either the new Medicare Be Read More . . .

ODH Requires Community Benefit Documents from Hospitals July 1

06/12/2018

Tax-exempt hospital should have received a letter from the Ohio Department of Health dated May 29 restating requirements to submit community benefit documents by July 1. This state requirement was enacted in July 2016 and requires that all tax-exempt hospitals submit community health needs assessment and improvement plans to ODH. It Read More . . .

New Medicare Cost Reporting E-Filing Effective June 12

06/11/2018

The new Medicare Cost Reporting e-filing system went into effect June 12. The April 30 MLN Matters Article MM106011 explains the new e-filing system is intended for cost report staff submitting annual Medicare Cost Reports, or MCRs, to Medicare Administrative Contractors, or MACs, for services provided to Medicare ben Read More . . .

OHA Publishes Ohio Medicaid Billing, Reimbursement FAQ

06/08/2018

OHA’s Health Economics & Policy Team has been working closely with ODM and corporate partner BKD, LLC over the past several months to review Medicaid claims submitted to Ohio’s Medicaid Payers since the Ohio Medicaid inpatient and outpatient rebase and EAPG implementation occurred in July and August of 2017. As a res Read More . . .

BWC Clarifies Behavioral Health Services in New Rule

06/08/2018

Effective July 1, a proposed new rule, OAC 4123-6-33, would govern the Ohio Bureau of Workers' Compensation reimbursement for health and behavior assessment and intervention, or HBAI, services. HBAI service codes have been included in the BWC Professional Provider & Medical Services Fee Schedule since 2008. However, his Read More . . .

SFY 2018 Hospital Cost Report Posted

06/07/2018

The Ohio Department of Medicaid has posted the SFY 2018 Hospital Cost Report and instructions on its website. A link to download the files can be found here. The completed cost report must be postmarked on or before June 30 for hospitals filing with a cost reporting period ending between July 1, 2017 and Dec. 31, 2017. For hospital Read More . . .

Archive Copy: June 7 OHA HCAP Update Webinar

06/07/2018

OHA’s Health Economics & Policy team on June 7 hosted a webinar, " OHA HCAP Update.” An archive copy of the webinar is available here. A copy of the PowerPoint presentation for the session is available here. Read More . . .

ODM's Hospital Policy Team Issues Updates

06/06/2018

Ohio Department of Medicaid's Bureau of Health Plan policy on June 1 provided updates on EAPG issues that for the past several months have been impacting providers that bill under the new outpatient reimbursement grouper for Ohio Medicaid’s patient population.Additional topics addressed in ODM’s update at the Large P Read More . . .

ODM Announces Downtime to Presumptive, Deemed Eligibility Portal

06/04/2018

ODM on June 1 announced providers will experience downtimes to the Presumptive and Deemed Eligibility Portal due to system upgrades to incorporate cash and food assistance status into beneficiaries' records. Providers will experience downtimes during the following upgrade periods: June 29 @ 6 p.m. – July 2 @ 6 a.m.July 1 Read More . . .

Ohio Medicaid Postpones Hospital Rate Cut

06/04/2018

The Ohio Department of Medicaid yesterday confirmed to OHA that the department will be further postponing its proposed 5 percent rate cut and will not cut hospital rates for the remainder of calendar year 2018. The department also announced it would reduce the proposed inpatient recalibration and eliminate the outpatient recalibrati Read More . . .

Register Now for the OHA, FHA Annual Medicare 101 Training

06/01/2018

The Ohio Hospital Association and Florida Hospital Association are teaming up again to present a comprehensive review of Medicare provider reimbursement systems and cost reporting July 26 in Columbus. The popular annual “Medicare 101” seminar is designed for trustees and hospital employees who are new to health care faci Read More . . .

Register for June 7 HCAP Update Webinar

05/29/2018

Join the Ohio Hospital Association Health Economics & Policy team and the Ohio Department of Medicaid for a webinar covering Ohio Hospital Care Assurance Program.June 710 to noon (ET)The webinar is free to OHA members and registration is now open at the link here. After registering, you will receive a confirmation Read More . . .

Save the Date for OHA, FHA at Annual Medicare 101 Training

05/25/2018

The Ohio Hospital Association and Florida Hospital Association are teaming up to present a comprehensive review of Medicare provider reimbursement systems and cost reporting July 26 in Columbus. The popular annual “Medicare 101” seminar is designed for trustees and hospital employees who are new to health care facility f Read More . . .

CMS Summer Webinar Series Starts June 6

05/18/2018

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 . . .

Anthem Announces New Commercial Facility Reimbursement Policy

05/17/2018

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 Works with ODM to Improve Communications Through Medicaid Managed Care Contracts

05/17/2018

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 . . .

Medicare A & B Providers Join WPS GHA & CGS in Louisville, KY

05/16/2018

Join WPS Government Health Administrators and CGS Administrators, LLC in Louisville, KY on June 12 for a collaborative event covering the following topics of interest for all A/B Providers: Billing during a leave of absence (LOA/interrupted stay)What “hospital bundling” includesHow to determine the proper patient status Read More . . .

Archive Copy: May 8 OHA Webinar on ODM Retrospective Claims Review

05/15/2018

OHA’s Health Economics & Policy team on May 8 hosted a webinar, " KEPRO: ODM Retrospective Claims Review.” An archive copy of the webinar is available here. A copy of the PowerPoint presentation for the session is available here. Read More . . .

CareSource Provides Operational Updates to OHA

05/15/2018

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 . . .

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

05/11/2018

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 reach out to Shawn Stack Read More . . .

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