EDITOR’S NOTE: Former CMS official Matthew Albright, now a legislative consultant for Zelis and a RACmonitor contributor and Monitor Monday’s panelist, will continue his reporting
The defendants were charged in seven district courts spanning the country. The locations of the seven U.S. Attorney’s Offices that this week brought healthcare fraud
Brooks-LaSure will become the first Black person to lead the federal agency responsible for the administration of the Medicare and Medicaid programs. The federal agency
CMS says the proposed rule is intended to enhance medical workforce in rural and underserved communities. Long-awaited and eagerly anticipated the Centers for Medicare &
The federal holiday honoring King is annually held on the third Monday in January. The executive body of a prominent nationwide healthcare organization has issued
Comments are being sought now. With two COVID-19 vaccines now being distributed nationwide and more on the way, in addition to what are sure to
Moderna’s vaccine is expected to be shipped to providers nationwide, on the heels of Pfizer’s. A reeling nation couldn’t have asked for a better Christmas
The list will be eliminated over the course of three years. Federal officials unveiled the 2021 Outpatient Prospective Payment System (OPPS) Final Rule this week,
EDITOR’S NOTE: Lisa Banker, MD contributed to the following report. Medicare Advantage Organizations (MAOs) were warned by federal health officials last week to issue an appealable
Action applies to the Medicare Accelerated and Advanced Payment Loan Program. In March, the Centers for Medicare & Medicaid Services (CMS) expanded the Accelerated and
Medicare spending on acute-care inpatient hospital services will increase by about $3.5 billion in FY 2021 As the healthcare industry continues to be buffeted by
The headlines have been coming fast and furious: Judge rules against hospitals in price transparency lawsuit (June 2020) Hospitals to challenge loss on site-neutral payments
Medicare regulations are complex and even seasoned professionals struggle to apply them consistently. Due to overwhelming demand, Dr. Hirsch returns for Part 2 of Ask Dr. Hirsch: Clarifying Medicare’s Most Misunderstood Rules to answer even more of Medicare’s most misunderstood questions, covering inpatient status, observation, SNF access, Medicare Advantage denials, and more. Join Dr. Hirsch as he provides clear, referenced answers to real-world questions submitted by your peers, helping you navigate Medicare compliance with confidence and clarity.
Traditional utilization management models can no longer keep pace with regulatory shifts, payer scrutiny, and operational pressures. In this webcast, Tiffany Ferguson, LMSW, CMAC, ACM, ACPA-C, introduces an Adaptive Model strategy that modernizes UM through role specialization, technology-driven workflows, and proactive, team-based processes. Attendees will learn how to restructure programs to improve efficiency, strengthen clinical collaboration, and enhance financial performance in a rapidly changing healthcare environment.
Federal auditors are intensifying their focus on inpatient psychiatric facilities, using advanced data analytics to spotlight outliers and pursue high‑dollar repayments. In this high‑impact webcast, Michael Calahan, PA, MBA, Compliance Officer and V.P., Hospital & Physician Compliance, breaks down what regulators are really targeting in IPF-PPS admissions, documentation, treatment and discharge planning. Attendees will learn practical steps to tighten processes, avoid common audit triggers and protect reimbursement and reduce the risk of multimillion-dollar repayment demands.
In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.
Prepare for FY 2027 IPPS changes with a comprehensive 3-part masterclass covering ICD-10-CM/PCS updates, MS-DRG shifts, NTAPs, compliance risks, and reimbursement strategies.
Stay ahead of FY 2027 reimbursement changes with expert analysis of MS-DRG shifts, NTAP updates, Medicare Code Edits, and emerging technologies impacting inpatient payment accuracy.
Stay ahead of FY 2027 ICD-10-PCS changes with expert analysis of new procedure codes, revised guidelines, and high-impact updates affecting reimbursement, compliance, and inpatient coding accuracy.
Master the FY 2027 ICD-10-CM changes, including new diagnosis codes, CC/MCC updates, and coding guideline revisions, with practical insights from nationally recognized coding and CDI experts.
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