I’m working on a U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) audit wherein the question invites the reviewer to
As artificial intelligence (AI) becomes increasingly embedded in the U.S. healthcare system, the lack of comprehensive federal regulation has created something of a vacuum –
A recent ruling out of New York is the latest notable step in a very long-running saga involving alleged healthcare fraud by Omnicare, a Pharmacy
Let me start with a warning. Hardly a day goes by that we don’t hear a story about the wonders of artificial intelligence (AI). And
I have recently seen providers receiving notices of alleged overpayments for relatively small amounts, say $10,000 or $20,000. These figures might strike a provider as
Federal contractors – Recovery Audit Contractors (RACs) and Unified Program Integrity Contractors (UPICs) – have increasingly targeted wound care claims, particularly involving expensive skin substitutes
My association, 340B Health, represents hospitals that participate in the federal 340B drug pricing program. It has been an incredibly busy summer, with many new
Let me start with a recently published audit of a home care agency, Sunflower Home Health in Cleveland Mississippi. During a two-year audit period, the
The Trump administration has recently announced what it’s calling a “digital health ecosystem” that will allow for millions of Americans to upload personal health data
January 2024 marked a significant change for the application of the Two-Midnight Rule for Medicare Advantage (MA) plans, when the Centers for Medicare & Medicaid
1. Payment & Reimbursement Changes For Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) site-neutral payments, the Centers for Medicare & Medicaid
Last week, President Trump unveiled his administration’s Artificial Intelligence (AI) Action Plan for America, a sweeping, 90‑point policy initiative aimed at securing U.S. dominance in AI
During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.
Learn how to navigate the proposed elimination of the Inpatient-Only list. Gain strategies to assess admission status, avoid denials, protect compliance, and address impacts across Medicare and non-Medicare payors. Essential insights for hospitals.
RACmonitor is proud to welcome back Dr. Ronald Hirsch, one of his most requested webcasts. In this highly anticipated session, Dr. Hirsch will break down the complex Two Midnight Rule Medicare regulations, translating them into clear, actionable guidance. He’ll walk you through the basics of the rule, offer expert interpretation, and apply the rule to real-world clinical scenarios—so you leave with greater clarity, confidence, and the tools to ensure compliance.
Bring your questions and join the conversation during this open forum series, live every Wednesday at 10 a.m. EST from June 11–July 30. Hosted by Chuck Buck, these fast-paced 30-minute sessions connect you directly with top healthcare experts tackling today’s most urgent compliance and policy issues.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY26 IPPS, including new ICD-10-CM/PCS codes, CCs/MCCs, and MS-DRGs, plus insights, analysis and answers to your questions from two of the country’s most respected subject matter experts.
This third session in our 2026 IPPS Masterclass will feature a review of FY26 changes to the MS-DRG methodology and new technology add-on payments (NTAPs), presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.
This second session in our 2026 IPPS Masterclass will feature a review the FY26 changes to ICD-10-PCS codes. This information will be presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.
This first session in our 2026 IPPS Masterclass will feature an in-depth explanation of FY26 changes to ICD-10-CM codes and guidelines, CCs/MCCs, and revisions to the MCE, presented by presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.
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