On March 26, the following four entities agreed to pay roughly $62 million to settle a whistleblower’s allegations under the False Claims Act: The allegations
Today I’d like to share some background about the critical role that utilization management (UM) plays during public emergencies, particularly based on our experiences during
Let me start with an update on a story I have covered previously. A surgeon recently took to social media to complain about being pulled
I really did hope to avoid having to criticize a Medicare contractor again, but then I got an email from a hospital. But first, I
Last Friday night, at nearly the last moment, Congress was able to keep the federal government open by passing a continuing resolution (CR) – that’s
The Centers for Medicare & Medicaid Services (CMS) has the authority to recoup alleged overpayments from healthcare providers before the full adjudication of an appeal.
I know you are wondering, so I am happy to report that I just went a whole week without watching a webinar. But luckily, I
Since Jan. 20, it seems that uncertainty in healthcare has become the new normal. After a contentious hearing, Robert F. Kennedy, Jr. was appointed to
While we’ve obviously got some big news coming out of the U.S. Department of Health and Human Services (HHS), today I wanted to give you
As you may recall, last week I defended two payers that faced unwarranted outrage on social media. But if you read my Thursday article, you
In this article, I wanted to tie into what contributor Matthew Albright was recently talking about relative to what’s going on in home and community-based
Following President Trump’s move into the Oval Office and his administration getting set up in the federal agencies, we’ve seen unprecedented movement on certain legislative
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.
Fraud convictions don’t just punish a few bad claims; they can wipe out years of reimbursements. Don’t wait for an audit to learn the rules. Join Frank Cohen, MPA, for a live Q&A on spotting red flags, avoiding liability, and protecting your practice. Register now and bring your questions!
Substance abuse is everywhere. It’s a complicated diagnosis with wide-ranging implications well beyond acute care. The face of addiction continues to change so it’s important to remember not just the addict but the spectrum of extended victims and the other social determinants and legal ramifications. Join John K. Hall, MD, JD, MBA, FCLM, FRCPC, for a critical Q&A on navigating substance abuse in 2025. Register today and be a part of the conversation!
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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