CMS released the CY 2019 IPPS(Inpatient Prospective Payment System) and LTCH(Long Term Care Hospital) with the purpose to reduce regulatory burden for inpatient hospitals and increase price transparency and better data sharing between hospitals and other providers and suppliers. One of the changes finalized in the CY 2019 IPPS/LTCH rule was the updated guidelines to the requirement for hospitals to post their standard changes in a machine readable format, on the internet, by January 1st of 2019. This requirement has generated numerous questions.
Implementing a requirement like this can be difficult for hospitals, and our expert Jugna Shah will equip providers with the right information and important considerations, so that they can make the best decisions on how to comply with the updated guidelines, and how to integrate this requirement into their overall price transparency strategy and patient communications.
Participants will be able to:
- Understand the price transparency requirement, and the minimum needed for compliance
- Learn how the guidelines were updated in the CY 2019 IPPS Final Rule, and the additional information CMS has released since the rule was published
- Learn how other providers are approaching complying with the requirement differently
- Learn what trade-offs between risk and patient-friendly materials on prices
- Learn what questions and decisions need to be discussed with leadership
- See examples of how disclaimer language can be crafted, and the importance of informing patients that what is displayed is not necessarily what they will pay
In this webinar, we will address these questions and subjects:
- What is meant by “standard charges”?
- Do hospitals have to post the entire chargemaster? What parts of the chargemaster can be included or excluded?
- Given that CPT codes are the intellectual property of the AMA, can hospitals post CPT codes as part of their CDM?
- Are hospitals allowed to summarize portions of the chargemaster?
- What can be done to make the chargemaster information more meaningful to patients?
- What is meant by “machinereadable format” in the requirement?
- Should hospitals post a disclaimer about their chargemaster information? If so, what kind of language should be included?
- How should hospitals prepare their public relations and communications teams about potential impacts as a result of posting the chargemaster and other information?
- Background of the requirement and the updated guidelines
- What additional information CMS has released
- How other providers are approaching the issue of price transparency
- Hospital Administrators
- Finance Directors
- Health Information Department
- Revenue Cycle Department
- Coding and Billing Staff
- CDM Managers
- Department Managers
- Compliance Officers
- Industry Organizations
About the Presenter:
Jugna Shah, MPH is a nationally recognized expert with over 20 years of experience in healthcare financing and regulatory systems. She is a frequent speaker at local, regional, national and international conferences. She is a founder of Nimit Consulting Inc. which specialize in providing information on regulatory initiatives and policies that affect healthcare service delivery, quality, cost, accessibility and compliance. She helps clients address a wide range of needs by analyzing operational and financial challenges, conducting coding, billing, coverage and compliance reviews. Ms. Shah’s areas of specialty include medical and radiation oncology, bone marrow and stem cell transplant billing and reimbursement, new cellular and gene therapies, pharmacy and drug coverage and more
A successful advocate, Ms. Shah has raised important payment system concern to the Centers for Medicaid and Medicare Services(CMS) and many of her recommendations have been accepted and implemented resulting in operationally simpler payment systems with more appropriate reimbursement for certain types of services for providers nationwide
Ms. Shah also works internationally on case-mix design, system development, implementation initiatives. She has led several World Bank and US Agency for International Development(USAID) healthcare financing reform initiative that involves providing long-term policy and technical assistance to foreign governments. From 2007-2016, Ms. Shah served in two officer positions of an international case-mix organization. called Patient Classification Systems International (PCSI), first as Secretary and then as Vice-President.
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