◆ There are signs of life to the national hospital reviews of short stays and high-weighted MS-DRGs (HWDRGs). A CMS spokesperson said Avar Consulting, a Beneficiary and Family-Centered Care Quality Improvement Organization (BFCC-QIO), “has been tasked to collect medical records relative to HWDRGs during the procurement process.” However, Avar Consulting won’t do the reviews. “The contractor is performing a medical record collection function in advance of contract award to expedite processing,” the spokesperson said. CMS will select a new contractor for the audits. Last year, it suspended short-stay and high-weighted MS-DRG reviews by two QIOs in favor of consolidating them with one national contractor.
◆ CMS said it will put out a Comparative Billing Report (CBR) in late March on lower extremity joint replacement.[1] The report will focus on providers who submit Medicare Part B claims. CBRs are not publicly available, because they’re only sent to Medicare Part B providers who are outliers. CMS’s CBR contractor has generated at least 10 CBRs on different risk areas, including office visits, subsequent hospital visits, emergency department services and Vitamin D testing.[2]