As we inch closer to a federal government shutdown, we finally have some big updates for you from the U.S. House of Representatives. But that
I have recently seen providers receiving notices of alleged overpayments for relatively small amounts, say $10,000 or $20,000. These figures might strike a provider as
The Trump administration has recently announced what it’s calling a “digital health ecosystem” that will allow for millions of Americans to upload personal health data
The One Big Beautiful Bill Act, signed into law on July 4, 2025, includes sweeping changes to Medicaid including work requirements, cost-sharing, eligibility verification, and federal
By now you have likely heard about Congress moving the “One Big Beautiful Bill” over the past few weeks to fulfill President Trump’s desire to
Since its creation in 1965, Medicaid has served as a lifeline for low-income individuals, families, and the disabled, offering health coverage in partnership with state
Last week, the Centers for Medicare & Medicaid Services (CMS) released its 2026 Budget Request and Justification to Congress, asking for $2.288 billion. I will
Perhaps inspired by the song “Month of May” on The Suburbs album by Arcade Fire, the Centers for Medicare & Medicaid Services (CMS) is coming
A new wave of Recovery Audit Contractors (RACs) and Unified Program Integrity Contractors (UPICs) have swept across the nation, empowered to root out fraud in
Let’s start today with a report that five Florida hospitals are suing Leapfrog Group over their receiving poor ratings. The hospitals, all part of Tenet,
Although specifics remain under negotiation, early outlines and House resolutions suggest that Medicaid will face significant reductions, likely through a combination of structural funding changes
The Trump Administration has put a hold on a federal program designed to increase oversight of hospice care, which receives over $25 billion annually from
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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