The 2-Midnight Rule: BFCC-QIO Audits and Medical Necessity in 2017

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The 2-Midnight Rule: BFCC-QIO Audits and Medical Necessity in 2017 - On-Demand

Product Code: YH102716D

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The 2-Midnight Rule: BFCC-QIO Audits and Medical Necessity in 2017 - On-Demand

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Available ON-DEMAND

Presented on:
Thursday, October 27, 2016

Presented by: 
Ralph Wuebker, MD, MBA
Steven A. Greenspan, JD, LLM

Sponsor: 
Medicare Compliance Watch
HIM Briefings

Level of Program: 
Intermediate

Increased scrutiny of the 2-midnight rule and medical necessity by the Beneficiary and Family Centered Care-Quality Improvement Organizations (BFCC-QIO) is set to ramp up again and may be more challenging than ever for hospitals now that contractors have been retrained. Analyzing the state of 2-midnight rule and short stay audits will help arm healthcare facilities with the tools they need to ensure compliance and prepare for BFCC-QIO audits. This webcast will unravel the complexities involved in defining one- and two-midnight stays for inpatient admissions and will provide the latest updates to medical necessity.

Join expert speakers Ralph Wuebker, MD, MBA, and Steven A. Greenspan, JD, LLM, as they discuss the current state of auditors and provide guidance on preparing for audits as healthcare facilities plan for 2017. Wuebker and Greenspan will also cover the latest patient status and medical necessity regulatory updates.

At the conclusion of this program, participants will be able to:

  • Adjust their hospital’s utilization review activities to support consistent admission reviews 
  • Properly assess admission decisions in light of recent CMS interpretations 
  • Proactively avoid inappropriate denials 


Who Should Listen?

  • IM directors and managers 
  • Compliance officers 
  • Revenue cycle managers 
  • Billing managers 
  • Coding managers 
  • Case managers 
  • Utilization review 
  • Physicians 
  • Physician advisors 
  • Medical directors 
  • Nursing 


Agenda 

  • Definition of appropriate one-midnight and two-midnight stays for inpatient admissions 
  • Strategies for complying with the last 2-midnight rule regulations 
  • Analysis of BFCC-QIO audits to date and strategies for preparing for an audit 
  • Tips for providers to avoid referrals to Recovery Auditors 
  • The impact of BFCC-QIO audits on the habits of other reviewers 
  • Q&A 


Tools 

  • BFCC-QIO flowsheet 


Continuing Education

ACCME
HCPro is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

HCPro designates the live version of this educational activity for a maximum of 1 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity. (Ability to claim CEU’s for this webcast expire on: 10/26/2017 - 1 year from LIVE date)

AHIMA
(Live + On Demand) - This program has been approved for 1 continuing education unit for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor. (Ability to claim CEU’s for this webcast expire on: 10/27/1


Meet the Speakers

Ralph Wuebker, MD, MBA
Ralph Wuebker, MD, MBA,
is chief medical officer for EHR in Newtown Square, Pennsylvania. He is board certified and currently serves as a member of EHR’s physician education and audit team. Wuebker regularly visits EHR’s client hospitals to provide medical executives and staff members with ongoing education on a variety of topics, including Medicare and Medicaid compliance and regulations, medical necessity, recovery audit contractors, utilization review, denials management, and length of stay.

 

Steven A. Greenspan, JD, LLM
Steven A. Greenspan, JD, LLM,
is vice president of regulatory affairs at Executive Health Resources (EHR) in Newtown Square, Pennsylvania. He is responsible for overseeing regulatory research and hospital advocacy efforts, and collaborates closely with EHR’s appeals management teams to offer support on complex Medicare, Medicaid, and commercial appeals matters. During his 18-year career, Greenspan has overseen the adjudication of more than 200,000 appeals and personally authored more than 10,000 appeal decisions. Prior to joining EHR, he served as vice president and project director for MAXIMUS Federal Services, Inc., overseeing the company’s Part A East QIC project. 


Webcast system requirements and program materials: 

To fully benefit from the webcast experience, please note you will need a computer equipped with the following: 

Browser: Microsoft Internet Explorer 6 or later, Firefox, Chrome, or Safari, with JavaScript enabled 
Internet: 56K or faster Internet connection (high-speed connection recommended) 
Streaming: for audio/video streaming, Adobe Flash plug-in or Safari browser on iOS devices 

Two days prior to the webcast, you will receive an email with detailed system requirements, your login information, presentation slides, and other materials that you can print and distribute to all attendees at your location. 

COULDN'T LISTEN LIVE? 
No problem. The On-Demand version is now available. Use it as a training tool at your convenience—whenever your new or existing staff need a refresher or need to understand a new concept. Play it once or dozens of times. A $259 value! 

PLEASE NOTE 
Participation in the webcast is just $259 per site. All materials must be retrieved from the Internet. 

Call your customer service representative toll-free 800-650-6787 or email customerservice@hcpro.com if you have questions.