CMS Provides Update Regarding Patient Status Review Delay – On July 27, 2016 CMS posted an update regarding Quality Improvement Organization (QIO) reviews of patient status claims, which are currently paused.  CMS notes that it believes that the QIO review pause will be lifted within 90-120 days. In addition, CMS clarified the instructions and look-back period for QIO review of claims impacted by the review pause. The CMS update is available here, and an FAQ is available here.

Second Chance to Watch the King & Spalding Roundtable Online on Provider-Based Status Changes and OPPS/MPFS Proposed Rules -- On July 21, 2016, King & Spalding hosted a Life Sciences & Healthcare Roundtable on the major provisions of CMS’s CY 2017 Outpatient PPS and Physician Fee Schedule Proposed Rules. The OPPS Proposed Rule includes CMS’s attempt to implement Section 603 of the Bipartisan Budget Act of 2015, which directs CMS to pay for most items and services furnished in new off-campus provider-based departments at the applicable non-facility payment rate.  Because of the strong demand for the original Roundtable, we are now providing access to an on-demand Webcast. There are no restrictions on who may register, and there is no charge. This Webcast will be available until August 15.  More information is available here.