Articles and Blogs

NATIONAL No-frills micro hospitals with as few as 8 rooms emerge as a new way to cut health-care costs Doctors can now call Uber for patients, ditching taxi vouchers Ocular Telehealth Battle Heats Up With New Group, Lawsuit Appeal Bracket partners with Uber Health to ease clinical trial site, patient burden A New taskforce... READ MORE

After informal communications with the Centers for Medicare & Medicaid Services (“CMS”) Central Office, it appears that edits that impact Critical Access Hospital (“CAH”) Method II claims have been overreaching. Specifically, reason codes 17713, 17714, 17716 and 17717 should not be applying to the facility charges on CAH Method II claims. These reason codes... READ MORE

On Tuesday, February 27, 2018, Attorney General Jeff Sessions announced the creation of the U.S. Department of Justice (“DOJ”) Prescription Interdiction & Litigation (“PIL”) Task Force in an ongoing effort to curb the country’s current prescription opioid crisis. According to DOJ’s press release, the PIL Task Force will “aggressively deploy and coordinate all available... READ MORE

On February 23, 2018, the Centers for Medicare & Medicaid Services (“CMS”) issued guidance that may result in fewer denials of claims made by Inpatient Rehabilitation Facilities (“IRFs”) for services (“Guidance”). Based on the Guidance, beginning March 23, 2018, Medicare contractors cannot make claim denials exclusively on the basis of a failure to meet... READ MORE

NATIONAL CMS moves forward with new voluntary bundled payment AMA seeks MAT changes to combat opioid crisis 35 hospital groups urge court to halt $1.6B in Medicare payment cuts 20 states file lawsuit against federal government calling the Affordable Care Act unconstitutional Moody’s warns hospitals to beware of payer growth strategies on margins, bargaining... READ MORE

NATIONAL EHR interoperability, connectivity a big challenge around globe new study finds AHA Asks CMS to Delay New Bundled Payment Model Anthem amends ER policy but stands behind decision not to pay for avoidable emergency care Albertsons, Rite Aid deal creates U.S. supermarket and health care giant Health experts suggest signing bank loans at... READ MORE

In February of 2017, the U.S. District Court for the Eastern District of Texas ordered a Texas hospital (the “Hospital”) “to immediately submit to the National Practitioners Data Bank a Void Report” regarding a physician whose clinical privileges were restricted by the Hospital’s medical executive committee, resulting in a report to the National Practitioner Data... READ MORE

NATION All 71 new 2017 ASCs by specialty Follow the money: Inpatient surgery moving out of hospitals into ambulatory centers Study: Only one-quarter of clinicians comfortable with value-based payment program Amazon eyes another healthcare shake-up: Getting into supply chain AHA recommends CMS delay application deadline for BPCI Advanced Gottlieb Outlines FY 2019 Budget Goals... READ MORE

NATIONAL Medical bills rise after hospitals acquire physician practices, studies suggest Dialysis provider Fresenius hit with $3.5 million HIPAA fine DOJ Memo Brings Promising News for Providers Facing Government Action Medicare pay cut dropped from spending bill passed by House Former CMS Administrator Andy Slavitt to create ‘United States of Care’ Coalition of 44... READ MORE

On October 1, 2017, the Centers for Medicare & Medicaid Services (“CMS”) implemented its national targeted probe and educate (“TPE”) program. TPE is designed to reduce improper payments by identifying providers/suppliers with high denial rates or unusual billing practices and providing education to correct non-compliance with claim submission criteria. However, repeated errors could potentially... READ MORE