Financial Assistance Policies of Charitable Hospitals

In recent years, hospitals and health systems have faced an increase in delivering charitable care and, as a result, have adjusted their policies and approach in order to fulfill their charitable care obligations. Authored by four healthcare provider executives, this HFMA white paper provides background on charity care in the United States, examples of the charity care processes currently used, and recommendations that could better support the federal government’s goals for charity care. To view the White Paper click HERE.

2013 OIG Work Plan Now Includes Anesthesia

Anesthesia Services -Payments for Personally Performed Services (New)

 “We will review Medicare Part B claims for personally performed anesthesia services to determine whether they were supported in accordance with Medicare requirements. We will also determine whether Medicare payments for anesthesiologist services reported on a claim with the “AA” service code modifier met Medicare requirements. Physicians report the appropriate anesthesia modifier to denote whether the service was personally performed or medically directed. (CMS’s Medicare Claims Processing Manual, Pub. No. 100-04, ch.12, @ 50) The service code “AA” modifier is used for anesthesia services personally performed by an anesthesiologist, and the “QK” modifier is used for medical direction of two, three, or four concurrent anesthesia procedures by an anesthesiologist. The QK modifier limits payment at 50 percent of the Medicare-allowed amount for personally performed services claimed with the AA modifier. Payments to any service provider are precluded unless the provider has furnished the information necessary to determine the amounts due. (Social Security Act, @1833(e).)”

(OAS; W-00-13-35706; various reviews; expected issue date: FY 2013; new start)

Resource:  OIG 2013 Work Plan