CMS Hospital CoP UR Planning Standards 2019
Preventing unnecessary readmissions is essential. Hospitals that have a higher rate of readmission now receive less money from CMS. There is increased surveillance activity in the area of discharge planning due to these changes. So what's in your organization's UR plan?
- Documenting regarding medical necessity and compliance with the Two Midnight Rule
- MOON forms required for outpatient observation patients
- Three revised tag numbers and UR committee requirements
Program Highlights
CMS UR Committee to Reduce Patient Readmissions
- What to include when redrafting your discharge planning evaluation form
- The 3 tag number revisions
- New requirements for UR planning - guidance for providers
Utilization Review under Tag 652 & Standardized Reporting
- Ensure federal compliance - changes required by CMS
- The elements you must measure and what audit contractors are looking for
- Last changes regarding accreditation organizations assessing compliance with UR standard
Prepare for Changes and Updates: Guidance for Hospitals, CAHs & Home Health
- What information must be included in your UR plan
- MOON Forms for outpatient observation patients
- Review of physicians and non-physician providers
Live Question & Answer Session - Have your questions answered by the expert!
About the Speaker
Sue Dill Calloway is president of Patient Safety, Healthcare Consulting and Education company, which focuses on medical legal education especially the Joint Commission and the CMS hospital CoPs regulatory compliance. She lectures on legal, risk management and patient safety issues. She was a director for risk management and patient safety for five years for the Doctors Company. She was the past VP of Legal Services at a community hospital in addition to being the Privacy Officer and the Compliance Officer. She was a medical malpractice defense attorney for ten years.
- Sue has 3 nursing degrees in addition to a law degree.
- She is a well known lecturer and the first one in the country to be a certified professional in CMS.
- Sue also teaches the courses for the CMS certification program. She has written over 100 books and thousands of articles
Program Benefits
It is important to establish medical necessity especially in light of the RAC program so hospitals do not owe large sums of money. This program will cover the CMS hospital Conditions of Participation regulations for Utilization Review. Every hospital that accepts Medicare and Medicaid reimbursement must be compliance with these standards. Compliance with the UR standards is more important than ever.
HRCI Credits
This program has been approved for 1 (HR (General)) recertification credit hour toward aPHRTM, aPHRiTM, PHR®, PHRca®, SPHR®, GPHR®, PHRiTM and SPHRiTM recertification through the HR Certification Institute. Learn more at hrci.org
Purchase this On-Demand Workshop
CMS Hospital CoP UR Planning Standards 2019
$299 + applicable taxes
You will receive access to the live event(s) which includes a copy of the speaker's presentation, real-time training with our expert instructor, and an interactive question & answer period. Two to three business days after each live training concludes, an email is sent to registrants which contains a link for unlimited access to the on-demand recording you can revisit & review.
You'll receive a link to access the recording(s) in your order confirmation email. On-demand recordings also include a copy of the speaker's presentation and the ability to submit your questions to the expert, for up to 7 days after viewing.
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