August 2012
The essential resource for your practice
Volume XXI, Number 8

CMS Releases Final IPPS Rule

On August 1, the Centers for Medicare & Medicaid Services (CMS) released the final Inpatient Prospective Payment System (IPPS) rule, which updates Medicare payment policies and rates for inpatient stays in acute-care hospitals under the IPPS, and also hospitals under the Long-Term Care Hospitals Prospective Payment System. The rule takes effect as of October 1, 2012.

Table of Contents


Coding Corner:

Essential Training for Urology Coding Beginners

U.S. Senate Raises Prostate Cancer Awareness By Passing Resolutions

On July 26, 2012, U.S. Senator John Kerry (D-MA) introduced Senate Resolution 529 (link removed), which recognizes the prostate cancer epidemic in the African-American community, and calls on federal agencies to support education, outreach and research in this high-risk population, with support of co-sponsors Sens. Daniel Akaka (HI), Ben Cardin (MD), Saxby Chambliss (GA), Daniel Inouye (HI) and Ron Wyden (OR).

On Wednesday, August 1, 2012, the Senate unanimously passed Resolution 538 declaring September 2012 National Prostate Cancer Awareness Month.

For The Record

AUA Urges PQRS Participation

Are you participating in the Physician Quality Reporting System (PQRS), the Centers for Medicare & Medicaid Services’ (CMS) voluntary reporting program?  If you aren’t, you should be.

Currently, PQRS provides a financial incentive for eligible professionals who satisfactorily report data on certain quality measures for Medicare Part B services paid under the physician fee schedule. However, this benefit will sunset. Calendar year 2012 is the last year eligible professionals can potentially earn a 0.5 percent incentive without their participation tied to a payment adjustment. 

CMS Releases Proposed Rules

Late Friday afternoon on July 6, 2012, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Hospital Outpatient Prospective and Ambulatory Surgical Center (ASC)  Payment Systems, and the Medicare Physician Fee Schedule proposed rules.          The American Urological Association (AUA) will review the changes outlined in both the proposed rules and provide a summary to our members in the upcoming weeks. The AUA will also provide written comments to CMS on the proposals outlined in each of the rules by the September 4, 2012, deadline.

About the Rules
The Medicare Hospital Outpatient/Ambulatory Surgical Center Proposed Rule would revise the outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center payment system for CY 2013 to implement applicable statutory requirements and propose changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, CMS is proposing updates and refinements to the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, the ASC Quality Reporting (ASCQR) Program, and the Inpatient Rehabilitation Facility (IRF) Quality Reporting Program.