Special Bulletin

Today is the first day that prior authorization is required for Medicare beneficiaries to undergo specific surgeries. Here are the 10 things you need to know about the program. Five types of surgery – blepharoplasty, botulinum toxin injections to the face, panniculectomy, rhinoplasty, and vein ablation – performed on traditional…
The changes will be applicable to some 67 million enrollees.   The approximately 67 million Americans with either Medicare Advantage (MA) or Medicare Part D health plans will enjoy more benefits and options following the implementation of changes federal officials announced just prior to the start of Memorial Day weekend.…
There is continued confusion over the use of patient homes as off-campus, provider-based clinics for Medicare billing purposes. This is the provision in the Centers for Medicare & Medicaid Services’ (CMS’s) second recent Interim Final Rule (IFR) that allows hospitals to bill for services provided by employed hospital staff, such…
A familiar development emerges amid unprecedented regulatory change.   Amid unprecedented regulatory upheaval recently instilled by the ongoing COVID-19 viral pandemic, federal officials unveiled a familiar sight earlier this week, when they issued a new proposed rule for the Inpatient Prospective Payment System (IPPS). The Centers for Medicare & Medicaid…
May 11, 2020

News Alert: New Waiver for Swing Beds

By Chuck Buck
Acute-care hospitals are to use their beds for “swing services” when necessary. EDITOR’S NOTE: In a surprise move, the Centers for Medicare & Medicaid Services (CMS) released a new waiver on May 11, allowing all acute-care hospitals to use their beds for “swing bed services” when necessary. Dr. Ronald Hirsch,…
Long-term care facilities nationwide have been particularly hard-hit by the viral pandemic.   The Centers for Medicare & Medicaid Services (CMS) has released a memo and FAQ sheet in advance of an interim final rule, expected to be released on Friday, that will update notification requirements for confirmed and suspected…
The ousting of Christi A. Grimm comes amid a series of OIG removals, developments that are concerning lawmakers and editorial boards alike.   “The first messenger that gave notice of Lucullus’s coming was so far from pleasing Tigranes, that he had his head cut off for his pains; and no…
As the nation continues to reel from the COVID-19 pandemic, a silver lining could be that the art of storytelling may be making a comeback.  EDITOR’S NOTE: Veteran RACmonitor and ICD10monitor Copy Editor and Correspondent Mark Spivey has spent the last seven weeks with his wife at their home in…