News & Information

Influenza in ICD-10-CM is classified in the following categories:

  • J09 Influenza due to certain identified influenza viruses – this includes the following types:

o   Avian

o   Bird

o   A/H1N1

o   Swine

o   Other influenza of animal origin (not bird/not swine) 

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Medicare plans to start a Skilled Nursing Facility Value-Based Purchasing Program (SNFVBP), beginning fiscal year 2019. This program will be used to promote better clinical outcomes for skilled nursing facility patients and improve care during their stay at a skilled nursing facility.   Skilled nursing facilities will be paid for participating. Starting the summer of 2016 then quarterly Medicare will send confidential quality feedback reports on measurement performance; the results will be posted on Nursing Home Compare.

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It is important for providers to understand the critical nature of the Business Associate Agreement (BAA). Far too many healthcare providers are neglecting this component of HIPAA, which can be a costly mistake. For years providers have been warned that if they are a HIPAA Covered Entity (CE) they MUST have properly executed BAAs for all their business associates. Failure to do so could cost millions. Penalties begin at $50,000 per violation with a maximum of $1.5 million per year for repeats of the same violation.

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On February 16, 2016, CMS, in conjunction with major commercial health plans and physician groups, released the first set of core measures, which will be used as the basis for quality-based payments. Part of the MACRA - SGR repeal was to begin to implement payment systems based on quality measures rather than the previous PPS system. This announcement marks the beginning of this process.

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NAMAS Weekly Auditing and Compliance Tips

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