CMS CoPs Utilization Review Standards 2023
9:00 – 10:30 a.m. Central time
NDHA Member Registration fees: $225 per facility
Non-Members Registration Fee: $350 per facility
Chief Medical Officer, Chief Nursing Officer, Compliance Officer, Emergency Department Personnel, Joint Commission Coordinator, Medical Records, Quality Improvement personnel, Risk Manager, Legal Counsel.
This program will cover the Centers for Medicare & Medicaid Services (CMS) hospital Conditions of Participation regulations for Utilization Review (UR). Each hospital that accepts Medicare and Medicaid reimbursement must comply with these standards. Facilities must comply with the UR standards to avoid penalties from the Recovery Audit Contractors (RACs) and other organizations such as the Office of Inspector General (OIG).
This webinar will discuss what is typically found in a UR plan and why hospitals get cited by CMS. Information will also be provided about deficiency reports. This program will also examine the Medicare Outpatient Observation Notice (MOON) form required for outpatient observation patients which was revised in 2020 along with revisions to the detailed notice and Important Message (IM) notice.
In this webinar, you can expect to learn:
- Recall that the hospital must have a UR plan.
- Discuss the importance of documentation of medical necessity by the physician in the
- Recite that hospitals are required to have a UR Committee.
- Describe the basics and rationale of the MOON notice.
Laura A. Dixon served as the director of risk management and patient safety for the Colorado Region of Kaiser Permanente. Prior to joining Kaiser, she served as the director, facility patient safety and risk management and operations for COPIC from 2014 to 2020. In her role, she provided patient safety and risk management consultation and training to facilities, practitioners, and staff in multiple states.
Dixon has more than 20 years of clinical experience in acute care facilities, including critical care, coronary care, peri-operative services, and pain management. Prior to joining COPIC, she served as the director, Western region, patient safety and risk management for The Doctors Company in Napa, California. In this capacity, she provided patient safety and risk management consultation to the physicians and staff for the western United States As a registered nurse and attorney, Dixon holds a Bachelor of Science degree from Regis University, RECEP of Denver, a Doctor of Jurisprudence degree from Drake University College of Law, Des Moines, Iowa, and a Registered Nurse Diploma from Saint Luke’s School Professional Nursing, Cedar Rapids, Iowa. She is licensed to practice law in Colorado and California.
This speaker has no real or perceived conflicts of interest that relate to this presentation.