Publications, Papers and Articles
Ms. Shah is committed to providing education and information about APCs and OPPS, and is involved in numerous publications that reach industry leaders and providers. She is the author of many articles on the APCs/OPPS system and its impact on health care delivery. Ms. Shah has served as a contributing editor and a guest columnist for several leading industry publications, including APC Answer Letter (APCAL) and the APC Weekly Monitor. She writes the OPPS Advisor column for Briefings on APCs. Ms. Shah has also authored and contributed to several books. Learn more about these resources.
2009
NEW: Stay tuned for a new book on Injections and Infusions - expected release in 2009/2010.
- CMS releases 2009 OPPS final rule; trends continue: Agency implements
most proposals
Briefings on APCs, January 1, 2009
- On the march toward value-based purchasing: How far does OPPS go in
measuring quality or utilization?
Hospital Peer Review, Jan/Feb 2009
2008
- Advisory panel speaks
out against proposed decrease in separately payable drug
reimbursement for 2009
Briefings on APCs, December 1, 2008
- Eliminate unnecessary imaging services to meet planned APC payment reductions in 2009 OPPS proposed rule
Briefings on APCs, October 1, 2008
- CMS proposes five new composite APCs, reduces drug reimbursement
New outpatient quality measures and more
Briefings on APCs, September 1, 2008
- Medically unlikely edits remain a puzzle to providers
Briefings on APCs, June 1, 2008
- Drug administration challenges continue
New information in CPT Manual creates more questions for providers
Briefings on APCs, April 1, 2008
- Check out observation criteria changes
CMS opens door for observation payment
Briefings on APCs, March 1, 2008
- Take a closer look at expanded packaging for 2008
Briefings on APCs, February 1, 2008
- 2008 OPPS final rule a radical change, sources say
Briefings on APCs, January 1, 2008 - Eliminate unnecessary imaging services to meet planned APC payment reductions in 2009 OPPS proposed rule
2007
- New Status Indicators Further CMS Packaging
Innovations
Report on Medicare Compliance
www.AISHealth.com
November 2007
- Final OPPS Approach to Observation Has No Link to Diagnoses - but Don't Cheer Yet
Report on Medicare Compliance
www.AISHealth.com
November 2007
- Wholesale OPPS packaging
CMS proposes paying for encounters
Briefings on APCs, September 1, 2007
- No E/M Coding Guidelines for Hospitals in Near Future, But CMS Unveils 'Principles'
Report on Medicare Compliance
www.AISHealth.com
July 2007
- Train your staff on drug administration charge capture
Learn one facility’s method of conquering injections and infusions
Briefings on APCs, July, 2007
- Coding Q&A: Experts tackle drug administration problems
(part 3)
Briefings on APCs, July, 2007
- Coding Q&A: Experts tackle drug administration problems
(part 2)
Briefings on APCs, June, 2007
- Coding Q&A: Experts tackle drug administration problems
(part 1)
Briefings on APCs, May, 2007
- OPPS final rule contains a few surprises for providers
Many proposals tweaked for final rule
Briefings on APCs, January, 2007 - Final OPPS Approach to Observation Has No Link to Diagnoses - but Don't Cheer Yet
2006
- “Take a Glimpse at What APC/OPPS Changes May Be In Store in 2007” OPPS Advisor Column. Briefings on APCs. May 2006.
- “New CMS Guidance Places Stiff Units of Service Limits on Drug Administration Codes” Briefings on APCs. April 2006.
- “Learn the Basics of 2006 Drug Administration Changes” Briefings on APCs. March 2006.
2005
- “2006 OPPS final rule delivers stunning drug administration rules and more: Bad news for drug reimbursement rates, good news for observation, diagnostic imaging” Briefings on APCs. December 2005.
- “New drug administration codes don’t paint a pretty picture: AMA preview reveals host of billing concerns for hospitals” Briefings on APCs. November 2005.
- “Provider Roundtable Issues Thoughts and Recommendations on the 2006 OPPS Proposed Rule” OPPS Advisor Column. Briefings on APCs. October 2005.
- “2006 Proposed Rule Released Much Earlier than Expected” OPPS Advisor Column. Briefings on APCs. September 2005.
- “Keep abreast of fluctuating drug payment rates: Changing APC payments could impact your bottom line” OPPS Advisor Column. Briefings on APCs. August 2005.
- 2005 OPPS Drug Administration Strategies Your Comprehensive Guide to Accurate Coding, Billing and Charging Marblehead, MA: HCPro. May 2005
- APC Advisory Panel meeting provides glimpse of 2006. OPPS Advisor Column. Briefings on APCs. February, 2005
- “Drug Administration in 2005: CMS creates clarity - and questions" OPPS Advisor Column. Briefings on APCs. February, 2005
2004
- Drug Revenue Toolkit.
- “Two Federal Registers Create Numerous Changes for OPPS 2004.” OPPS Advisor Column. Briefings on APCs. February 2004.
- “How to Stay Ahead of the OIG by Conducting an Internal Audit Today.” In APCs/OPPS and Compliance: New Perspectives. Association of Healthcare Internal Auditors (AHIA), Spring, 2004. (New Perspectives is a quarterly educational journal published by the Association of Healthcare Internal Auditors (AHIA). It reflects the association's mission by providing members with new perspectives on healthcare internal auditing.)
- Outpatient Auditing Strategies. HCPRO. 2004.
- “Critical Compliance Issues in OPPS.” In Compliance Troubleshooter: Tackling the Top 10 Compliance Challenges. Marblehead, MA: HCPro. 2004.
2003
- The Final OPPS Rule: Not as Hard to Live With as We Thought. (OPPS Advisor Column). December 2003.
- CMS Doesn’t “Disappoint”: Proposed 2004 OPPS Rule Could Have Massive Impact. (OPPS Advisor Column). September 2003.
- Your CDM Needs These Changes! (OPPS Advisor Column). August 2003.
- Shah, J. The Outpatient Prospective Payment System, Now and Later. Chapter in Compliance Troubleshooter. HCPRO 2003.
- FI Policies Differ in Coding Q0081 with Chemotherapy Administration. Special Web Article for HCPRO. April 2003.
2002
- CMS Issues Final 2003 OPPS Rule, Increases Payment Rates. (OPPS Advisor Column). December 2002
- CMS isn’t Ready for
2002 HOPD OPPS Changes -- But You Need to be. Briefings on APCs (OPPS
Advisor Column). January 2002.
- Testifying before CMS on
the 2003 Rules. Briefings on APCs (OPPS Advisor Column). April
2002.
- New CMS Memos Toss More Changes into the 2002 Rules. APC Answer Letter (APCAL). May 2002.
2001
- A Look at the OPPS Changes Proposed for January 2002. Briefings on APCs (OPPS Advisor). October 2001
- Sometimes, Change Can be a Good Thing. Briefings on APCs (OPPS Advisor). June 2001.
- The Good, the Bad, and the
Ugly of APCs. Briefings on APCs (OPPS Advisor). April 2001.
2000
- Are You an APC-Savvy Hospital? Briefings on APCs (OPPS Advisor Column). August 2000.
- Managing the Outpatient Revenue Cycle. Briefings on APCs (OPPS Advisor Column). October 2000.
- Understanding the implications
of Medicare’s Outpatient Code Editor on Reimbursement. Briefings
on APCs (OPPS Advisor Column). July 2000.
1999
- Outpatient Prospective Payment System Implementation: Opportunities for Hospitals and Ambulatory Surgery Centers. In Ambulatory Care Services and Prospective Payment. N. Goldfield and W. Kelly (Eds.). Gaithersburg, MD: Aspen Publishing. 1999.
- Preparing for Outpatient
Prospective Payment System Implementation. In Ambulatory Care Services
and Prospective Payment. Goldfield, N. and W. Kelly (Eds.). Gaithersburg,
MD: Aspen Publishing. 1999.
1998 and previously
- The New Medicare Hospital
Outpatient Prospective Payment System: A Special Report from 3M Health
Information Systems. Salt Lake City, Utah: 3M HIS. November 1998.
- The Budgetary and Political Effects of a DRG-Based Budgeting Health Care System. (Report to the National Health Informatics Center, Hungary, and The General Health Insurance Company, Czech Republic). Silver Spring, MD: 3M HIS. December 1996.
