MedPAC Suggests Streamlining Emergency Department Coding So That There Would Be National Guidelines
The suggestion from the Medicare Payment Advisory Commission comes as scrutiny of emergency department visits and spending has increased as the healthcare industry shifts towards more value-based care. MedPAC also weighed in on Medicare Advantage payments.
Modern Healthcare:
MedPAC Recommends National ED Coding For Medicare
The Medicare Payment Advisory Commission officially asked HHS to create a national guideline for coding all emergency department visits by 2022. Currently hospitals make their own guidelines that can be based on resources from the American Hospital Association or American College of Emergency Physicians, but commission members were worried about a lack of consistency. (King, 4/4)
Modern Healthcare:
MedPAC Turns To MA Payment Withholding To Improve Encounter Data
A key Medicare advisory panel wants Congress to pass legislation to withhold a portion of Medicare Advantage plan payments and not return it if the insurer's encounter data is incomplete or inaccurate. The Medicare Payment Advisory Commission, which passed the recommendation during its April meeting Thursday, wants Congress to direct the CMS to start withholding in 2021 and release standards and performance metrics that plans can meet to get it back. (King, 4/4)
