Regulatory Updates

Read APL 17-009 (PDF) and DPL 17-002 (PDF) for information regarding Provider-Preventable Conditions. Visit Reporting of Provider Preventable Conditions for DHCS instructions for online reporting. By clicking on these links, you will be leaving the IEHP website.

Medicare Outpatient Observation Notice (MOON)

In the event any Medicare recipient has been in a status of outpatient observation for greater than 24 hours, Acute Hospitals are required to provide Medicare Members with a Medicare Outpatient Observation Notice (MOON). Medicare recipients must receive the MOON within 36 hours of admission to observation level of care.

 

Please refer to the following website for further details on MOON requirements at https://www.federalregister.gov/articles/2016/08/22/2016-18476/medicare-program-hospital-inpatient-prospective-payment-system-for-acute-care-hospitals-etc.  By clicking on this link, you will be leaving the IEHP website.

 

Document Catalog:

  1. MOON FAQs (PDF)
  2. MOON Instruction Summary (PDF)
  3. CMS Manual System 10611_Pub 100-04 Medicare Claims Processing MOON Instructions (PDF)
  4. MOON Forms
  5. MOON Correspondence (PDF)

 

Medicare-Medicaid (MMP) Quality Withhold Measures

 

You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.