tci Medicare Compliance & Reimbursement - 2008 Issue 23
Industry Notes: Advisory Opinion Approves Hospital's Software That Communicates With Physicians' EHRs
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Article Overview
This article summarizes several Medicare and CMS policy developments affecting hospitals, physicians, and other providers. It covers an advisory opinion related to a hospital software arrangement that interfaces with physicians’ electronic health records, a CMS test of new quality measures for a future physician reporting program, and revisions to Medicare claims appeals procedures. It is useful for compliance, revenue cycle, and quality reporting professionals who need a high-level scan of current regulatory activity.
Why This Topic Matters
These updates may affect compliance planning, quality reporting preparation, and appeals management for healthcare organizations.
Article Sections
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Advisory Opinion on Hospital Software and EHR Communication
Discusses a CMS advisory opinion involving a hospital’s proposed software arrangement and its interaction with physicians’ electronic health record systems. The section frames the compliance and referral-law context at a high level.
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Other News
Provides brief industry news items on Medicare fraud activity in South Florida, CMS testing of new quality measures for future reporting use, and updates to claims appeals procedures.
What You Will Learn
- The general compliance context for a hospital software arrangement involving physician EHR systems
- How CMS is testing new quality measures for possible future reporting use
- That Medicare appeals procedures have been revised and may affect provider workflows
- Why regional fraud enforcement trends may be relevant to claims review planning
Who Should Read This
- Hospitals
- Physicians
- Compliance officers
- Revenue cycle professionals
- Quality reporting staff
- Healthcare administrators
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