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The history, design, and classification rules of the DRG system, as well as its application to patient discharge data and updating procedures, are presented in the CMS DRG Definitions Manual (Also known as the Medicare DRG Definitions Manual and the Grouper Manual). A new version generally appears every October. The 20.0 version appeared in 2002.
The Improving Medicare Post-Acute Care Transformation Act of 2014 or the IMPACT Act of 2014 would amend title XVIII of the Social Security Act to direct the United States Secretary of Health and Human Services to: (1) require post-acute care (PAC) providers to report standardized patient assessment data, data on quality measures, and data on ...
This provides a basis for describing the types of patients a hospital or other health care provider treats (its case mix). Case mix groups are used as the basis for the Health Insurance Prospective Payment System (HIPPS) rate codes used by Medicare in its prospective payment systems. [1]
APCs or Ambulatory Payment Classifications are the United States government's method of paying for facility outpatient services for the Medicare (United States) program. A part of the Federal Balanced Budget Act of 1997 made the Centers for Medicare and Medicaid Services create a new Medicare "Outpatient Prospective Payment System" (OPPS) for hospital outpatient services -analogous to the ...
Factors Influencing Health Status and Other Contacts with Health Services 939 - 951 24 Multiple Significant Trauma 955 - 965 25 Human Immunodeficiency Virus Infection 969 - 977 MDC Category Missing 981 - 989; 998,999
The Medicare Payment Advisory Commission has urged the federal government to restructure the hospice benefit to remove such incentives by reducing payments for longer stays, warning that such changes are “imperative.” The Centers for Medicare and Medicaid Services has the authority to reform the system but has not adopted the proposed changes.
In 2007, the Centers for Medicare and Medicaid Services (CMS) put forth a report to Congress called "Promoting Greater Efficiency in Medicare. [8]" In its section on readmissions, CMS made the case for closer tracking of hospital readmissions and tying reimbursement to lowering them, citing a 17.6% 30-day readmission rate for Medicare enrollees ...
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