The discounted drug program is viewed as vital for vulnerable populations. With all eyes on the U.S. Supreme Court, as pending landmark decisions on abortion
The enforcement arm of the federal health department has been busy, with more than 300 criminal enforcement actions in six months. Of any unsavory traits
The final rule is expected to be posted on the first Friday in August. The Centers for Medicare & Medicaid Services (CMS) has released the
As expected, the PHE was renewed another 90-days effective April 16th, 2022. “As a result of the continued consequences of the Coronavirus Disease 2019 (COVID-19)
The HHS Secretary and the President both issued statements pledging to do more for communities of color. “Of all the forms of inequality,” Dr. Martin
You have questions, we have answers. EDITOR’S NOTE: On Jan. 24, RACmonitor published a special bulletin authored by Dr. Hirsch on the manual changes to
Litigation is targeting the QPA, and its designation as the going rate for out-of-network providers. A number of provisions from the No Surprises Act took
The changes will become effective in about three months, giving providers time to modify processes. The staff at the Centers for Medicare & Medicaid Services
The settlement pertained specifically to H.I.G. Growth Partners and H.I.G. Capital. In recent years there has been a proliferation of private equity firms taking oversight of healthcare
Now, it’s merely a matter of day-to-day survival. EDITOR’S NOTE: In light of the fact that hospital nurses have reported a recent dramatic increase
All applicable waivers remain in place. As expected, Xavier Becerra, the Secretary of the U.S. Department of Health and Human Services (HHS), has renewed the
Livanta is sending documentation requests for short stay inpatient audits. Livanta, the Beneficiary and Family Centered Care-Quality Improvement Organization (BFCC-QIO) auditor, has started sending out documentation
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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