audit tools for potentially avoidable events medicare 2019

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Outcome and Assessment Information Set OASIS-D … – CMS

Jul 2, 2018 … Potentially avoidable events are negative outcomes that clinical evidence
indicates … OASIS D Guidance Manual: Effective January 1, 2019.

Public Comment Summary Report – CMS

Aug 31, 2018 … to assess potentially concerning patterns of care after hospice live discharge. ….
followed by death or acute care are unavoidable, from a quality of care …
7Medicare Program; FY 2019 Hospice Wage Index and Payment Rate Update ….
or auditing.16 If the Transitions measure were implemented for public …

Home Health Quality Reporting Program Technical Expert … – CMS

Aug 21, 2015 … current HHQRP outcome, process, and potentially avoidable event measures
and evaluate …. A validated pain assessment tool is necessary; rating pain from 1
-10 is not the best pain … She recently conducted an audit …… Calendar Year
2019 will help tremendously with the transfer of patient information.

2018 Quality Assurance Reporting Requirements – New York State …

Jan 11, 2018 … Potentially Preventable Mental Health Related Readmission Rate 30 ….
collection unit as per CMS for QARR reporting. … All submitted data must be
audited by certified auditors from NCQA ….. numerator events for NYS-specific
measures. … Instruments/QualityInitiativesGenInfo/Downloads/Revised_QRS- …

Audit template – Oregon State Legislature

Nov 29, 2017 … Our audit found that Oregon Health Authority (OHA) recovery efforts are …
resulted in millions of dollars of avoidable Medicaid expenditures, … Medicaid
and Medicare and are known as dual eligible. …. 2 Pilot projects designed to test
and measure the effect of potential …… activities by January 2019.

CMS Region 7 Updates – 06/29/2018 – Missouri Department of …

Jul 1, 2018 … New Medicare Card Mailing Update – Wave 3 Begins, Wave 1 Ends .. … Quality
Payment Program Participation Lookup Tool with Predictive Qualifying APM
Participant Status …. Upcoming Webinars and Events and Other Updates . …..
Potentially Preventable 30-Days Post-Discharge Readmission Measure …

HHS OIG Work Plan 2017 – OIG .HHS .gov

Nov 15, 2016 … This edition of the Work Plan describes OIG audits and evaluations that are
underway or planned and …… OIG developed the SNF adverse event trigger tool
as part of its study, … Potentially Avoidable Hospitalizations of Medicare- and
Medicaid-Eligible Nursing Facility …… Expected issue date: FY 2019.

FY 2017 SNF PPS final rule – Government Publishing Office

Aug 5, 2016 … Medicare Program; Prospective Payment System and Consolidated Billing for
Skilled Nursing … Centers for Medicare & Medicaid. Services … specifies a
potentially preventable …. RAI Resident assessment instrument …… this audit
process is quite extensive in …… FY 2019 SNF VBP Program, we believe.

Final Recommendation for the Potentially Avoidable … – HSCRC

Jun 9, 2018 … The PAU Savings policy is an important tool to maintain hospitals' focus on …
Medicaid Services (CMS) quality-based payment programs, which is …
Potentially Avoidable Utilization (PAU) may be defined as “hospital care that … 1
In RY 2019, HSCRC continues to determine PAU savings based on hospital.

CENTERS FOR MEDICARE & MEDICAID SERVICES WAIVER …

Jun 6, 2018 … Demonstration Population 7:Medicare beneficiaries with income at or ….
treatment where the utilization is preventable or medically ….. and audit
requirements as if it were a non-risk pre-paid inpatient …… waiver forms, as
instructed in the State Medicaid Manual. …… potential corrective action steps
toward.

Guide – ForwardHealth Portal – Wisconsin.gov

Mar 20, 2018 … V. Potentially Preventable Readmissions (PPR) . …. Dual (Medicare) eligible
members are excluded from BC+ and SSI …. specified by NCQA (e.g., HEDIS
2018 for MY2017, HEDIS 2019 for MY2018) when …. and is aligned with how
HEDIS auditors use HEDIS specifications. …. This forms the RIE baseline,.

Medi-Cal 2020 STC 11-22-16 – California Department of Health …

Nov 22, 2016 … Medicare & Medicaid Services (CMS) has granted waivers of statutory Medicaid
…. preventable dental conditions for Medi-Cal beneficiaries. III. ….. A discussion of
events occurring during the quarter or anticipated to occur in the …… CBAS
Assessment Tool: The State shall ensure that the plans shall comply.

Connecticut State Innovation Model Operational Plan – CT.gov

Feb 1, 2018 … State Innovation Model. CMS. Centers for Medicare and Medicaid …. Support
data analytics and deploy HIT tools, including a multi-payer solution for the … The
third award year (AY3) runs from February 1, 2018 – January 31, 2019 ……
Potentially Preventable Complications (PPCs) – are harmful events or …

FY 2018 Annual Medicaid Reform Report – Alaska Department of …

Nov 15, 2018 … submitted to the Centers for Medicare & Medicaid Services (CMS) in January
2018. … The anticipated managed care project go-live date is April 1, 2019. …..
handled through desk audits and provider training, while other, more ….. the
potential for 1) decreased adverse drug events and medication errors, …

INNOVATION PLAN HAWAI'I STATE HEALTH INNOVATION PLAN

Jun 2, 2016 … (SIM) awards from the Center for Medicare and Medicaid Innovation (CMMI) – a
Round One …. tools that support coordination among primary care, women's
health, and …… the Med-QUEST Audit for 2014 reported, “Despite growth in the
…. of potentially avoidable hospital use and second for the lowest rate …

SIM Award Year 3 Operational Plan – Iowa Department of Human …

Aug 1, 2017 … supports providers engaged in value-based care by providing tools … Iowa SIM
Goals by 2019: … Reduced rate of potentially preventable readmissions in Iowa
by 12% … Medicaid population that aligned with Medicare's ACO programs …
Medicaid and Wellmark, high attendance to SIM Learning Events by …

CENTERS FOR MEDICARE & MEDICAID SERVICES SPECIAL …

Demonstration Approval Period: October 30, 2014 through June 30, 2019 ……
address potential overlap in practice site selection, patient population, etc. ……
spending in the SNCP to comply with budget neutrality in the event that
expenditures under ….. 29 separate Forms CMS-64.9 Waiver and/or 64.9P
Waiver must be …

The State of Safety and Quality in Australian Health Care (PDF)

Medicare Benefits Schedule. MRSA … a relatively low rate of avoidable death
and good survival rates …. to highlight clinical events, adverse trends, and system
and … include data on surgical mortality, potentially …. By 2019–20, health
service organisations in a range …. community use audit tools and systems to
monitor.