Today I want to provide some clarifications to a couple of things I recently read. Now, I must say that correcting others is often viewed
From think tanks to federal agencies, health policy in the U.S. is often shaped by voices we don’t always see in the headlines. Abe Sutton,
According to the American Hospital Association (AHA), Medicare reimbursed hospitals at just 82 percent of the cost of care in 2022, meaning hospitals absorbed an
Today I have a few newsworthy items for you. First, Medicare updated one of the Manuals with information on billing for patients who are in
I think it is important to challenge one portion of an article that was widely distributed two weeks ago. The article included a statement that,
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
The U.S. Department of Justice (DOJ) announced that Texas rheumatologist Dr. Jorge Zamora-Quezada had been sentenced to 10 years’ imprisonment in connection with the submission
I am sure by now that many of you have heard the news that there is an ongoing criminal investigation into UnitedHealthcare’s Medicare Advantage (MA)
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,
Let me start with a wild Medicare Advantage (MA) denial of inpatient admission. This was a 75-year-old male who fell. The patent had chronic atrial
Let me start with a topic that was discussed by David Glaser during a recent Monitor Monday broadcast. He noted the federal regulation (42 CFR
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