Upcoming CRHC CAH Webinars

Click on the links below for more information and to register.
Utilization Management for CAHs – February 28, 2012
CAH Swing Beds Part I – March 20, 2012
CAH Swing Beds Part II – April 3, 2012

QHi Benchmarking Tool – Back to Basics Webinar

The next Quality Health Indicators (QHi) Back to Basics Training Session is scheduled for Wednesday, February 22, 2:00-3:00 Central Time. During this session QHi will review the basics of using the system. Additionally, they will review new enhancements to the site and upcoming measure changes. QHi is a benchmarking tool geared towards CAHs and rural hospitals under 50 beds. All Colorado CAHs can participate in QHi at no cost. Over 200 hospitals in 14 states use the tool. For more information contact jd@coruralhealth.org.

Medicare System to Include ‘Rendering Provider’ Field to Allow Correct Physician NPI Reporting for PCIP for CAHs Reimbursed Under Optional Method

Change Request (CR) 7686 instructs Medicare contractors to implement a system update to include the “Rendering Provider” field to allow correct physician National Provider Identifier (NPI) reporting for the Primary Care Incentive Program (PCIP) for CAHs reimbursed under the optional method. Upon implementation of CR 7686, CAHs reimbursed under the optional method should use the 837I version 5010A2 “Rendering Provider” field (loop 2310D) instead of the “Other Operating Physician” field (loop 2310C). The “Rendering Provider” field on the 837I must be populated by the eligible primary care practitioner’s NPI for the primary care services to qualify for the incentive bonus. Providers should continue to use loop 2310C, as well as the information that is required in loop 2310B defined as “operating physician,” for purposes of PCIP reporting until implementation of CR 7686. Effective July 1, 2012, providers should begin using loop 2310D. For more information, click here.

OSHA Respiratory Protection Videos

The OSHA Respiratory Protection Videos web page includes nine short videos that cover key compliance points for the Respiratory Protection Standard, 1910.134. The free videos, while not specific to healthcare settings, allow safety officers and trainers to access sections of the standard that apply to general industry, including healthcare. There is also an OSHA video specific for healthcare workers available on the Department of Labor website here that covers elements of the standard listed above.

CAH Conditions of Participation

The updated version of CMS’ State Operations Manual Appendix W “Regulations and Interpretive Guidelines for CAHs” has been updated with the latest updates to the conditions of participation regarding credentialing and privileging for telemedicine, advance directives, as well as patient visitation rights. The updated language is listed in red throughout Appendix W. To access the updated Appendix W, click here.

Determining Eligibility for the Medicare HPSA Physician Bonus Payment

Physicians who may be eligible for the Medicare Health Professional Shortage Area (HPSA) bonus payment should be aware of the following information and educational resources regarding determining eligibility, in order to minimize errors during the post-payment review process.


Information on the HPSA bonus, including the list of zip codes eligible for automatic payment, can be found at on the CMS website  here.
Two MLN Matters articles are available which go into further detail:
“2012 Annual Update for the HPSA Bonus Payments” (MM7517): here and
“HPSA Bonus Payment Policy Reminders” (SE1202): here.
Websites to help determine existing designations and eligibility for the Medicare HPSA physician bonus include: HPSA Find  – to identify designations within a state,
FFIEC– to identify census tracts by entering an address, and
Data Warehouse HPSA– to see if an area is listed as being in an eligible area.

Multiple Procedure Payment Reduction for Physician Services for Certain Diagnostic Imaging Procedures in CAHs

CMS Change Request (CR) 7684 informs Medicare contractors about the changes necessary to implement Multiple Procedure Payment Reduction (MPPR) for physician services for certain diagnostic imaging procedures in CAHs that have elected the optional method for outpatient billing. Payment is made to the CAH for physician services (revenue code 096X, 097X or 098X) on Type of Bill (TOB) 85X based on the Medicare Physician Fee Schedule (MPFS) supplemental file. Additional information is available on the CMS website here.