2012 Final Rule

• 2012 OPPS/ASC Final Rule
• 2012 IPPS Final Rule
• 2012 SNF Final Rule
• 2012 IRF Final Rule
• 2012 Hospice Final Rule

Centers for Medicare and Medicaid Services (CMS)

Payment Systems

• Ambulatory Surgical Center PPS
• End Stage Renal Disease PPS
• HIPPS: Inpatient Prospective Payment
• Home Health PPS
• HOPPS: Outpatient Prospective Payment
• Hospice Payment System
• Inpatient Psychiatric Facility PPS
• Inpatient Rehabilitation Facility PPS
• Skilled Nursing Facility PPS

Provider Types

• Hospital Information
• Conditions of Participation & Conditions for Coverage
• Ambulatory Surgery Centers
• Ambulance Services Center
• Critical Access Hospitals (CAH)
• Fee-For-Service Providers
• Home Health Agency Center
• Independent Diagnostic Testing Facilities
• Skilled Nursing Facility Center
• Independent Diagnostic Testing Facilities
• Long-Term Care Hospitals

The Health Insurance Portability & Accountability Act of 1996

• HIPPA
• Final Rule
• HIPAA Privacy Rule
• OCR - National Standards
• OCR -  HITECH Breach Notification Interim Final Rule
• Security and Transactions Standards Modifications

Publications

• Ambulance Services Claims Processing Manual
• Ambulatory Surgery Centers Claims Processing Manual
• Drugs and Biologicals Claims Processing Manual
• Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Claims Processing Manual
• Home Health Agency Billing 
• Hospice Claims Processing Manual
• Hospital Part A Manual
• Hospital Part B Manual
• Hospital Part B Outpatient Rehab and CORF/OPT Services
• Independent Diagnostic Testing Facility (IDTF) Claims Processing Manual
• Laboratory Services Claims Processing Manual
• Outpatient ESRD Hospital, Independent Facility, and Physician/Supplier Claims Processing Manual
• Physicians/NonPhysician Practitioner Claims Processing Manual
• Preventive and Screening Services Claims Processing Manual
• Program Memorandums & Transmittals 
• Radiology Services and Other Diagnostic Procedures Claims Processing Manual
• Rural Health Clinics/ FQHC
• Skilled Nursing Facility Part B Billing (Including Inpatient Part B and Outpatient Fee Schedule Manual
• Skilled Nursing Facility Inpatient Part A Billing and SNF Consolidated Billing Manual

CMS Guidance for Routine Nursing Services

• Benefit Policy Manual - Chapter 1/Section 1 & Section 20
• Benefit Policy Manual - Chapter 6/ Section 20.5.1
• CFR 412/2 - (c) Inpatient Operating Costs
• CFR 413.53 - (b) Definition Routine Services

Services

• Physician E/M Documentation Guidelines
• Physician Information
• Physician Fee Schedule
• Advisory Opinions

Medical Policy

• Local Coverage Determination (LCD)
• Medicare Coverage Policy
• National Coverage Determinations (NCD)

Billing

• National Correct Coding Initiative (NCCI)
• Medicare Coordination of Benefits
• Drugs

Provider Updates and Resources

• Quarterly Provider Update
• Questions & Answers
• Medicare Learning Network
• Hospital OPPS Fact Sheet

Government Resources

• Balanced Budget Act of 1997
• Federal Register
• Food & Drug Administration
• GPO Access A to Z On-Line Resources
• Regulations Gov
• Social Security Act - Table of Contents
• Title 42 Code of Federal Regulations (CFR)
• Title 42 United States Code (USC)
• Department of Justice (DOJ)
• Office of Inspector General (OIG)
• Fraud Enforcement
• Corporate Integrity Agreements
• Alerts/Bulletins/Other Guidance

Compliance

• JCAHO - Patient Rights
• IRS Revenue Ruling 97-21
• American College of Healthcare Executives - Code of Ethics
• Best Compliance Practices - Vendor Relations
• Standards of Ethical Conduct - Executive Branch
• CAP - Compliance Program
• HcPRO - Compliance Monitor Archive

EMTALA

• EMTALA

Hospital Standards

• Florida Hospitals
• Kentucky Medicaid
• Kentucky Hospitals
• Michigan Hospitals
• Minnesota Hospitals
• Missouri Hospitals
• New York Hospitals
• North Carolina Hospitals
• Ohio Hospitals

Fiscal Intermediaries

• Arkansas Medicare Services
• BCBS of Alabama
• BCBS of Arizona
• Cahaba Government Benefit Administrators
• Highmark Medicare Services
• Cigna HealthCare Medicare Administration
• First Coast Service Options
• Georgia Medicare Part A
• Kansas Medicare
• Noridian Administrative Services
• Palmetto GBA
• Regence BCBS
• Rhode Island Medicare
• TrailBlazer Health Enterprises, LLC
• National Government Services, Inc.