February 26, 2019

Centers for Medicare and Medicaid Services (CMS) Make Hospital Charges Available to the Public

For the first time, the federal government has made public chargemaster data for the 100 most common Medicare inpatient diagnostic related groups or DRGs. The data show that hospital prices often vary widely, even within the same within the same city or region. The massive file contains chargemaster data, or what some call the “sticker price,” for the 100 most common Medicare inpatient DRGs. The data does not include physician costs and does not show prices paid by Medicare. But it does provide an inside look at how average covered Medicare charges can significantly vary from hospital to hospital within the same city or geographic area. The data is for 3,400 hospitals and represents 92% of all hospital inpatient charges in […]
February 26, 2019

ISASS Meets with CMS Officials Regarding Reimbursement of Minimally Invasive Spine Surgery

ISASS Coding and Reimbursement Task Force Chair Dr. Morgan Lorio participated in a meeting with officials from Centers for Medicare & Medicaid Services, or CMS, to discuss reimbursement of minimally invasive spine surgery procedures in the Medicare Physician Fee Schedule.  The meeting occurred February 6, 2019, and was focused primarily on CPT code 27279, Minimally Invasive Sacroiliac Joint Fusion, which CMS has identified as potentially mis-valued in previous Medicare Physician Fee Schedules. CMS was represented by Director Carol Blackford; Ing-Jye Cheng, deputy director for the Office of the Department of Hospital and Ambulatory Policy Group (HAPG); and other officers in the Outpatient Care, Practitioner Services and Ambulatory Services Divisions, including Gift Tee, acting director of the Division of Practitioner Services, […]
January 29, 2019

U.S. Pain Management Task Force Releases Draft Report

The U.S. Department of Health and Humans Services (HHS) Pain Management Best Practices Inter-Agency Task Force recently released a draft report identifying gaps or inconsistencies and proposing updates to best practices and recommendations for pain management. The report comes after one year of regular meetings with the task force, which was authorized by section 101 of the Comprehensive Addiction and Recovery Act of 2016 (CARA). The group’s findings are critical for addressing the mounting public awareness of opioids and clinical efforts to reduce the number of opioids prescribed. The draft report released on Dec. 28, 2018, calls for individualized, patient-centered pain alleviation and management to improve the lives of those who experience acute and chronic pain. It contains proposed recommendations in […]
January 29, 2019

FDA Issues Warning Against Unproven Stem Cell Treatments

On December 20, 2018, the Food and Drug Administration (FDA) issued a warning letter to Genetech Inc., citing numerous deviations from current good manufacturing and tissue practices. The compliance issues were discovered during a facility inspection between June 18 and June 22, 2018. The agency also found that the company was engaged in the manufacturing and distribution of umbilical cord blood products, which were not the subject of an approved biologics license application nor an investigational new drug (IND) application—thereby violating the Federal Food, Drug, and Cosmetic Act and Public Health Service Act. The letter followed a recall of all ReGen Series products manufactured by Genetech, Inc. of San Diego, Calif., and distributed by Liveyon of Yorba Linda, Calif. On September 28, […]