Monthly Newsletter

February 2023 Monthly Newsletter

February is National Heart Health Month

It’s National Heart Health Month!

Cardiovascular disease is the world’s number one cause of death, killing over 17 million people every year, according to the World Health Organization (WHO).  So, what better time to emphasize the importance of cardiovascular health?

The CDC’s Vision for Heart Disease and Stroke Prevention has put together materials for dissemination purposes for both patients (factsheets) and health professionals.

The National Heart, Lung and Blood Institute offers free resources – download Fact Sheets and also offers social media resources where you can find images, motion graphics and sample posts to share to raise awareness about heart disease and how to prevent it.

New SDoH Codes Effective April 1, 2023

Social Determinants of Health (SDoH) ICD-10-CM Update

The Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) is implementing 42 new diagnosis codes into the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), for reporting effective April 1, 2023.

These new codes are implemented to improve the collection of health-related social needs (HRSNs) which is defined as individual-level adverse social conditions which negatively impact a person’s health or healthcare, are significant risk factors associated with worse health outcomes, and result in increased healthcare utilization.  Download the April 1, 2023 Official ICD-10-CM Guidelines and code files.

Register for the 2023 Capturing and Coding Social Determinants of Health (SDoH) for Physicians and Hospitals – a low-priced short course providing April 2023 updates!

Rural Emergency Hospitals (REH) Designation

Medicare’s Newest Provider Type

On Wednesday, January 26, 2023, the Centers for Medicare and Medicaid Services (CMS) released guidance for the newest Medicare provider type, Rural Emergency Hospitals (REH).  The Consolidated Appropriations Act (CAA), 2021 established Rural Emergency Hospitals (REHs) as a new Medicare provider and allows REHs to participate in the Medicare program and receive payment for items and services furnished on or after January 1, 2023.

The conversion of an eligible facility to an REH allows for the provision of emergency department services, observation care, and additional outpatient medical and health services. The CMS guidance outlines requirements related to the delivery of care, conversion process for eligible facilities, survey guidelines, and the Conditions of Participation that facilities must meet to participate in the Medicare program. Download the guidance for more information.

CMS Revises Hospital Beneficiary Notices – Effective April 27, 2023

Starting April 27, 2023, hospitals must use the new versions of the beneficiary notices.  CMS added revised standardized nondiscrimination language required on the forms and notices; other information on the notices remains the same.

Hospitals and CAHs are required to provide a MOON to Medicare beneficiaries (including Medicare Advantage health plan enrollees) informing them that they are outpatients receiving observation services and are not inpatients of a hospital or critical access hospital (CAH). Click Here for more information.

Hospitals are required to deliver the Important Message from Medicare (IM), formerly CMS-R-193 and now CMS-10065, to all Medicare beneficiaries (Original Medicare beneficiaries and Medicare Advantage plan enrollees) who are hospital inpatients. The IM informs hospitalized inpatient beneficiaries of their hospital discharge appeal rights. A Detailed Notice of Discharge (DND) is given only if a beneficiary requests an appeal.  The DND explains the specific reasons for the discharge. Click Here for more information.

Nursing Homes: OIG Oversight 2023

OIG Update 2023: Protect Residents from Fraud, Abuse, and Neglect and Promote Quality of Care

In a 2023 Office of Inspector General (OIG) update on Nursing Home oversight, the OIG work on nursing homes has uncovered widespread challenges in providing safe, high-quality care.

More than 1.4 million individuals live in over 15,500 Medicare/Medicaid-certified nursing homes across the United States. Most nursing homes are certified to serve as both skilled nursing facilities, providing a clinically managed recovery period after a person's illness or injury, and long-term care facilities that deliver health care and services for mental or physical conditions not rising to the level of skilled nursing care.

The OIG audits, evaluations, and investigations have raised concerns regarding staffing levels, background checks for employees, reporting of adverse events experienced by residents, and other issues. Learn More about the Key Goals in the OIG nursing home oversight.

OIG’s Second Report – Monitoring Nursing Home Infection Rates & COVID

1,000+ Nursing Homes Reached Infection Rates of 75% or More

The COVID-19 pandemic has been particularly devastating for Medicare beneficiaries in nursing homes, which is why OIG embarked on a three-part series of evaluations focusing exclusively on the nursing home experience.

For the health and safety of residents, nursing homes must be prepared to face current and future health emergencies. Understanding how the COVID-19 pandemic has affected nursing homes can help the CMS, Congress, and other stakeholders learn from what has happened and inform their decisions as they strive to improve care and better protect residents.

In January 2023, the OIG released the second report in the series and builds on the first OIG report by focusing on nursing homes themselves. It looks at the extent to which they had residents who were diagnosed with COVID-19 or likely COVID-19, and the characteristics of nursing homes with extremely high infection rates. The third report will feature specific challenges nursing homes faced and the strategies they used to deal with them. Download or read the January 2023 OIG Report.

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