4004 – Medicare Regulation Update for Case Managers
Every year Medicare releases thousands of pages of new rules that require case managers to make adjustments to their daily work processes. Recent rule changes have brought the 2 Midnight Rule and the MOON along with expansion of the bundled payment programs including the CJR. Each year the inpatient only list is changed requiring process change. The growth of Medicare Advantage seems to be continuing unabated, bringing new challenges on a seemingly weekly basis. In this talk, Dr Hirsch will review the pertinent hospital, hospice, and physician rule changes for 2020 that affect case managers.
1.Outline the changes brought on with the 2020 OPPS, IPPS, Hospice, and Physician Fee Schedule Rules
2.Differentiate the regulatory requirements between Medicare and Medicare Advantage plans and the impacts on the work of the case manager
3. Develop approaches to the case management workflow that incorporate all regulatory requirements and maintain a patient-centered care focus