While many in hospitals find understanding the new regulations on Medicare Advantage (MA) plan denials challenging, it appears that the payers are also having a difficult time adopting their practices. While we have talked a lot about Aetna’s policy and its “severity review,” another payer
Last month, the medical staff at a Twin Cities hospital were treating a patient for a traumatic head injury. The patient was brought in by
Many hospitals that participate in the 340B Drug Pricing Program faced a dilemma as their Medicaid census fell or was projected to fall below the
As of Jan. 1, the Centers for Medicare & Medicaid Services (CMS) initiated a three-year phase-out of the Inpatient-Only (IPO) List, which fundamentally reshapes how
You are probably aware that many Medicare Advantage (MA) plans are claiming that due to new rules issued by the Centers for Medicare & Medicaid
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