Impact on SNFs was foreseen in the IPPS proposed rule. Last week, the Centers for Medicare & Medicaid Services (CMS) followed up on President Biden’s
There must be rules and appeal rights for terminations. The pandemic rules/exceptions may be coming to an end on April 16, 2022. For example, as
Officials say vast reform is needed. With all eyes, both domestically and internationally, on Ukraine and its invasion at the hands of Russia, it strained
Both rules would do more than merely impact payment. Federal officials this week unveiled a pair of proposed rules that are likely to have significant
Federal officials seek enhancements to the Medicare program through payment realignment. The Centers for Medicare & Medicaid Services (CMS) has finalized Medicare rules adjusting payments
Based on latest filed Medicare cost reports, a little over 12 percent of all skilled nursing facility or “SNF” patients are Medicare recipients. This is
The new coronavirus is linked to 1,502 deaths among residents of nursing homes and assisted-living facilities in Florida, a new state report shows. It’s an
As some states begin to reopen, others are seeing increasing numbers of COVID-19 cases with hospitals reporting rising ICU utilization and near-capacity conditions. But one
Colleen Morley’s piece from Frontline Friday was so appreciated. As I read it, Colleen bravely understated what we as case managers, social workers, and their
Providers nationwide are seeking to identify ways to mitigate the uncontrolled spread of the virus amid vulnerable populations. Since the first American case of COVID-19
The COVID-19 pandemic has caused all of us to expand our minds. EDITOR’S NOTE: During recent weeks, the Centers for Medicare & Medicaid Services (CMS)
EDITOR’S NOTE: RACmonitor asked Dr. Ronald Hirsch to monitor the CMS townhall conference call on Tuesday. The following is his summary of that call. In
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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