While President-elect Trump’s pick for U.S. Department of Health and Human Services (HHS) Secretary, Robert F. Kennedy, Jr., put the agency in even international newspapers
Well, I gave you all a break from my criticism of insurance company policies and ploys last week, and I had planned to go for
The Centers for Medicare & Medicaid Services (CMS) issued the review copy of the Fee Schedule, Friday, Nov. 1. Usually, the final copy appears about
Some of you may have noticed that I am not always very nice to some insurance companies. And deservedly so. But I also point out
The day after Halloween, there were no treats for doctors. The Centers for Medicare & Medicaid Services (CMS) released the Medicare Physician Fee Schedule Final
The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) reported that a total of 11 health data breaches have each
Let me start with a few updates today. I discussed last week the national intravenous fluid shortage. What I had not heard at that point
With a week off, I have much to report today to catch up. First, many of you may have heard or read that Medicare has
In what feels like a final drive to exercise authority prior to the election, and a potential shift in control of the presidency and administration,
Rule 9(b) of the Federal Rules of Civil Procedure states that, in all averments of fraud, such as allegations concerning the False Claims Act, (FCA)
I want to thank Millie in Florida to pointing out something very important that happened last week which affects more than 300 hospitals around the
I was fortunate to obtain excerpts from an appeal letter submitted by a hospital in response to a Medicare Advantage (MA) denial from Humana. The
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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