FY 2019 IPPS Proposed Rule
May 1, 2018: CMS has made available its display version of the FY 2019 IPPS Proposed Rule, which is scheduled to be published on May 7, 2018. There are two Graduate Medical Education issues that we would like to highlight. Medicare GME Affiliated Group First, CMS is proposing to allow new urban teaching hospitals (i.e. hospitals that did not have residents in their FY 1996 cost reports) some...Read More
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Academic Medical Centers Can Be Paid for Non-Accredited Training Programs
May 1, 2018: Are you skeptical? Certainly the fiscal intermediary’s auditors are and also current CMS Hospital Payment Policy Staff have confused the matter. But, have heart and claim the costs. Here’s why! My analysis always begins with evaluating the intent of the Medicare Law. On this issue, the law clearly states that Medicare will share the Hospital’s cost of training. During my tenure...Read More
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Claiming Nonprovider Locations
March 14, 2018: In order to claim nonprovider locations on your IRIS report, there are several additional rules that you must consider. Our hope for you is that by the end of this article you will be able to identify if a facility is considered a nonprovider location, if the training in which the residents are participating is claimable for GME and IME, and the type of documentation that is...Read More
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Claiming Vacation Time
March 5, 2018: Reporting vacation time on the IRIS report can be tricky. Medicare regulations state that vacation time or leave of absence can be counted on the IRIS report as long as it does not prolong the total time of the resident’s training (42 CFR § 413.79(h)). It gets tricky when the resident that is on vacation is spending time in more than one hospital throughout the academic year....Read More
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