23. August 2012 · Comments Off · Categories: Health Law · Tags:

In its OPPS rule for 2013, CMS has asked for comments from hospitals as to whether there would be greater clarity “regarding patient status if there were more specific criteria for patient status in terms of how many hours a patient remains in a hosptial.”  In other words, would a “bright-line” test of, say, 24 hours determine whether someone is an inpatient under all circumstances? 

Clearly, the Recovery Auditors target “inpatient cases” becasue denials of inpatient status result in income for RACs. 

It is possible that a bright line test would result in a change of emphasis from review of the setting to review of the appropriatness of medical necessity.  Stay tuned – but comments are due September 4.

19. August 2012 · Comments Off · Categories: Health Trends, Living

The recent issue of Scientific American, which I heartily recommend, contains a short but interesting article on the two primary ways of achieving even greater longevity than we have now.  One, focus on the specific areas of the body that cause trouble and remove/regenerate/replace them.  Two, and alternatively, examine molecular development way down at the molecular level to adjust cellular development in order to “slow down” the aging process.  I am summarizing, of course, so read the article!  But what strikes me is that while living beyond 100 years may be desirable for some, as a society we truly need to address how such lives will be led, and under what conditions for the participants – mentally, socially, and physically.  Our medical and scientific knowledge, we should assume, will outpace our evolutionary and mental capacities for coping with this knowledge.