March 28, 2019

Medicare Reduces Payments to 800 Hospitals Citing Patient Safety Incidences

Medicare announced on March 1, 2019, that 800 hospitals will be paid less by Medicare this year because of high rates of infections and patient injuries. The number is the highest since the federal government five years ago launched the Hospital Acquired Conditions (HAC) Reduction Program, created by the Affordable Care Act. This year, 110 hospitals are being punished for the fifth straight time. The penalties pit hospitals against one another in a race to prevent the most infections, blood clots, cases of sepsis, bedsores, hip fractures and other complications. Each year, the quarter of general hospitals with the highest rates are punished, even if their records have improved from the previous year. Under the announced sanctions, each hospital will lose 1 […]
March 28, 2019

ISASS Meets with the Office of Management and Budget (OMB) 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 the Office of Management and Budget (OMB) to discuss reimbursement of minimally invasive spine surgery procedures in the Medicare Physician Fee Schedule. The meeting occurred March 19, 2019, and was focused on the undervaluation of spine surgical procedures in the Medicare Physician Fee Schedule. Dr. Lorio described two clear examples of mis-valuation of minimally invasive spinal procedure in CPT code 27279, Minimally Invasive Sacroiliac Joint Fusion, and 22867, Interlaminar Spinal Stabilization. The Centers for Medicare and Medicaid Services (CMS) have already identified as potentially misvalued in previous Medicare Physician Fee Schedules but have not changed the Relative Value Units (RVUs) for 27279. OMB […]