Between the No Surprises Act, Price Transparency regulations, and a variety of state laws and news articles, there is a great deal of scrutiny on
Running around crucifying healthcare providers for sloppy documentation is fool’s gold. The Recovery Audit Contractor (RAC) audit industry over time has degenerated into a framework
The agency still recovered more than $1 billion from healthcare providers. The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG)
Scammers targeted a local medical board in the name of the FBI. Here’s a story you need to share with your licensed professionals. Last week
Crime doesn’t pay, but it’s costing headaches for many. The COVID-19 vaccination program has stimulated one of the largest crime waves in history – and
Why doesn’t CMS use business intelligence to catch fraud? You can call it business intelligence. You can call it common sense. As Medicare pays fee-for-service
The head of a group of Michigan- and Ohio-based pain clinics and other providers will also have to pay $51 million in restitution. Federal officials
I have written four previous articles on Philip Esformes, who was sentenced to 20 years in federal prison for a truly infamous scheme to defraud
The final sum is slightly greater than the FY 2018 total. The federal government won or negotiated more than $2.6 billion in healthcare fraud adjustments
Covid-19 Opens up Vast Opportunities for Today’s Snake Oil Salesmen The COVID-19 crisis in the United States has opened vast opportunities for fraud of every
Conspiracy ran for nearly 20 years, netting owner of assisted living and skilled nursing facilities $37 million. The primary orchestrator of what federal authorities called
The common thread appears to be physicians willing to take money as administrators. As we recently reported, according to Assistant Attorney General Brian A. Benczkowski
Learn how to navigate the proposed elimination of the Inpatient-Only list. Gain strategies to assess admission status, avoid denials, protect compliance, and address impacts across Medicare and non-Medicare payors. Essential insights for hospitals.
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!
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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