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Split-Shared Visit Revisited Next Year

David M. Glaser, Esq. November 9, 2022

CMS will delay until next year a final decision on this contentious issue. Every year, around this time, I feel a bit like Steve Martin

CMS Final Rule Raises Ire, Poses Unanswered Questions

Ronald Hirsch, MD, FACP, CHCQM, CHRI November 9, 2022

CMS incorrectly uses the term “observation.” As expected, the Centers for Medicare & Medicaid Services (CMS) released the 2023 Outpatient Prospective Payment System (OPPS) and

CMS Unveils 2023 Physician Fee Schedule

Mark Spivey November 2, 2022

Key changes are pending in the areas of behavioral health, cancer screening, and dental – among others. The Centers for Medicare & Medicaid Services (CMS)

An Observation about Observation Rates (and Other Notes)

Ronald Hirsch, MD, FACP, CHCQM, CHRI November 2, 2022

Benchmark rates for observation depend on understanding your numerator and denominator. First up, a shout-out goes to my friend Dr. Charles Locke in Maryland, an

CMS Fails Audit and is Told to “Get More Money!”

Knicole C. Emanuel Esq. November 2, 2022

Three quick stories, each of Medicare money that has vanished, never to be found. First, a report from the U.S. Department of Health and Human

Why Has the Hospital Turned into Long-Term Care?

Tiffany Ferguson, LMSW, CMAC, ACM October 26, 2022

Often, the ability to move such a patient from the hospital into an appropriate setting is dependent on the social services in the local jurisdiction.

The Catastrophic Effect of Natural Disasters on Medicare Audits

Knicole C. Emanuel Esq. October 26, 2022

Medicare does not provide funding for financial losses. When natural disasters strike, Medicare and Medicaid audits become less important, and human safety becomes most important.

Winds of Change are Blowing for Some Medicare Advantage Plans

Jennifer L. Bartlett, CPAR October 26, 2022

Rumors persist of possible leadership changes at some Medicare Advantage plans in the mid-South region. From where I sit, which is very close to the

Scrutiny of MA Plans Continues Nationwide

Ronald Hirsch, MD, FACP, CHCQM, CHRI October 26, 2022

CMS used secret shoppers to call phone numbers advertised on television and discovered a lot of incorrect information and attempts by the agents to coerce

Regulation Nation

Matthew Albright October 19, 2022

A recent survey has illustrated just how onerous the various federal regulations of healthcare have become. If you’re feeling extra productive and accomplished this morning

Modern UR Stressors Demand Innovation

Paul Arias, RN, BSN, EJD, CMAC October 19, 2022

Hospitals and health systems are increasingly turning to innovative methodology to cope with staffing and budget constraints. Utilization review (UR) has been in place for

News

Split-Shared Visit Revisited Next Year

CMS Final Rule Raises Ire, Poses Unanswered Questions

CMS Unveils 2023 Physician Fee Schedule

An Observation about Observation Rates (and Other Notes)

CMS Fails Audit and is Told to “Get More Money!”

The Catastrophic Effect of Natural Disasters on Medicare Audits

Winds of Change are Blowing for Some Medicare Advantage Plans

Scrutiny of MA Plans Continues Nationwide

Regulation Nation

Modern UR Stressors Demand Innovation

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