A highly publicized UHC denial of care led to more questions than answers. By now many have read the ProPublica expose on how UnitedHealthcare (UHC)
Proposed rule calls amending regulations clarifying the determination as to whether a physician qualifies as a rehabilitation physician is made by the IRF. The Centers
Initial round of audits proves successful for therapy providers. Therapy providers in the Novitas JL jurisdiction have received good news on the initial round of
Military healthcare program expanding coverage following extensive lobbying campaign. The U.S Department of Defense has signaled the start of the process to authorize physical therapist
IRFs can breathe easier; no change in policy. CMS has clarified the question of counting minutes of therapy provided by students. The Inpatient Rehabilitation Facility
A brewing problem, or simply an area for clarification for IRFs? During what was expected to be a plain vanilla review of the Inpatient
CAR-T therapy could list a single service with a $1.4 million charge. I was honored to be able to speak at the annual meeting of
Legislation establishes the 2018 therapy cap level of $2,010 as a threshold level. The therapy caps have been eliminated! It has been a long and
Those involved in compliance will want to keep tabs on these changes with due concern. The Bipartisan Budget Act of 2018 (BiBA) was signed into
At the heart of underusing palliative care is that no person wants to inflict sadness on another. Among the synonyms for the adjective ‘brutal’ are
She had chosen palliative care as the medical therapy. EDITOR’S NOTE: Former First Lady Barbara Bush died Tuesday at age 92 at her home in
Pending a possible government shut down, this bill would allow documentation from a home health agency to be considered when records are reviewed. Late on
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!
Substance abuse is everywhere. It’s a complicated diagnosis with wide-ranging implications well beyond acute care. The face of addiction continues to change so it’s important to remember not just the addict but the spectrum of extended victims and the other social determinants and legal ramifications. Join John K. Hall, MD, JD, MBA, FCLM, FRCPC, for a critical Q&A on navigating substance abuse in 2025. Register today and be a part of the conversation!
Stop revenue leakage and boost hospital performance by mastering risk adjustment and HCCs. This essential webcast with expert Cheryl Ericson, RN, MS, CCDS, CDIP, will reveal how inaccurate patient acuity documentation leads to lost reimbursements through penalties from poor quality scores. Learn the critical differences between HCCs and traditional CCs/MCCs, adapt your CDI workflows, and ensure accurate payments in Medicare Advantage and value-based care models. Perfect for HIM leaders, coders, and CDI professionals. Don’t miss this chance to protect your hospital’s revenue and reputation!
Struggling with ICD-10-CM coding for diabetes and complications? This expert-led webcast clarifies complex combination codes, documentation gaps, and sequencing rules to reduce denials and ensure compliance. Dr. Angela Comfort will provide actionable strategies to accurately link diabetes to complications, improve provider documentation, and optimize reimbursement—helping coders, CDI specialists, and HIM leaders minimize audit risks and strengthen revenue integrity. Don’t miss this chance to master diabetes coding with real-world case studies, key takeaways, and live Q&A!
Uncover critical guidance. HIM coding expert, Kay Piper, RHIA, CDIP, CCS, provides an interactive review on important information in each of the AHA’s 2025 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.
Uncover critical guidance. Kay Piper provides an interactive review on coding guidelines and more in the AHA’s fourth quarter 2025 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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