There are now 200,000 new targets for CMS and private payers.

Since the first of this year, I have engaged in several audits for which the target is not the physician, but rather a physician’s assistant (PA) or a nurse practitioner (NP). While there have always been audit issues regarding the use ...

I am changing my interpretation of the final rule with help from the trenches.

Often referred to as the “carpenters” of medicine, orthopedic surgeons are not well-known for deep contemplation of Centers for Medicare & Medicaid Services (CMS) rules. But I’ll be damned if I haven’t had to wrestle ...

CMS has created a giant loophole that continues to perplex.

I get a lot of questions about status changes. To explain how even the seemingly simple questions are not always so easy, I want you to picture a patient. She is 75 years old and has a cough. She is insured by Medicare and has no ...

The promise of patients over paperwork may greatly benefit hospitals.

The Centers for Medicare & Medicaid Services (CMS) has posted the 2019 Inpatient Prospective Payment (IPPS) Proposed Rule, with the agency suggesting it would strip away language that a physician’s order must be in the medical ...