The Centers for Medicare & Medicaid Services (CMS) has announced a new approach to penalties applied under the Hospital Price Transparency rule. Before I describe
CMS is enforcing its rule with penalties. The Centers for Medicare & Medicaid Services (CMS) is focusing new funding and efforts on hospital price transparency
Benchmark rates for observation depend on understanding your numerator and denominator. First up, a shout-out goes to my friend Dr. Charles Locke in Maryland, an
Healthcare pricing is a complicated minefield. A recent RACmonitor article written by Govind Goyal described enforcement of the price transparency rule. At the Chicago-Kansas City
The new rule mandates that hospitals disclose their prices. Most providers already know that effective Jan. 1, 2021, the Centers for Medicare & Medicaid Services
The headlines have been coming fast and furious: Judge rules against hospitals in price transparency lawsuit (June 2020) Hospitals to challenge loss on site-neutral payments
The misconception is having to charge everyone the same price. There are so many misunderstandings about healthcare pricing and how it works. One of the
Last week, a federal court in the District of Columbia rejected arguments by the American Hospital Association (AHA) that the Price Transparency Rule slated to
The new rule contains two key requirements—annual disclosure of prices and 300 “shoppable” items. Effective Jan. 1, 2019, the Centers for Medicare & Medicaid Services
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.
Artificial intelligence is rapidly transforming healthcare revenue cycle operations, from coding and auditing to compliance and denials. Join industry leaders Pam Warren (MaineHealth) and Raemarie Jimenez (AAPC) for a live fireside chat exploring how AI is changing workflows, workforce roles, payer-provider dynamics, and compliance risk—and what organizations should be doing now to prepare.
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.
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