Featured Article

November 19, 2020

CoP Compliance in the Face of COVID 19: No Time to Cut Corners: Part 2

By Marvin D Mitchell, RN, BSN, MBA
Now more than ever it’s no time to cut corners. EDITOR’S NOTE: This article is an expansion of the original piece, “CoP Compliance in the Face of COVID-19: No Time to Cut Corners,” originally published April 1, 2020. Recent articles by Marie Stinebuck, Edward Hu, MD, and Stefani Daniels touch…
November 12, 2020

2020: The only Certainty is Uncertainty

By Matthew Albright
Expect to see legislation on bipartisan issues, such as drug pricing and balance billing. The Associated Press and broadcast networks announced on Saturday that former Vice President Joe Biden has won the 2020 presidential election. The Trump campaign and Republican groups have initiated a number of election-related lawsuits across the…
November 5, 2020

IRF Care Again in Audit Crosshairs

By Ronald Hirsch, MD
OIG determines admissions to inpatient rehab not appropriate. Last week, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released an audit of OSF Saint Francis Medical Center in Peoria, Ill. In this audit, the majority of the errors were once again due to admissions…
Hospitals could be charged $250,000 or twice the demand amount, whichever is greater. In October 2020, the United States Department of the Treasury’s Office of Foreign Assets Control (OFAC) issued an advisory on potential sanction risks for facilitating ransomware payments. It warned that entities, including hospitals, paying off ransomware extortion…
October 21, 2020

Auditors Are Ramping Up Operations

By Sean M. Weiss, CEMA, CMCO, CPMA, CPC-P, CMPE, CMPM, CPC-P
A culture of compliance is the key to success. There are no indications that audits of healthcare entities by government payers are slowing down – if anything, the ramping up of audit operations that was hinted at a short while ago has indeed materialized. Commercial payers are moving just as…
October 15, 2020

MSPB: Another Look at Cost and Efficiency

By John Zelem, MD
MSPB could be the “new normal” for length of stay. We have all gotten to hear that phrase – a “new normal” – over the past 6-9 months, as we have dealt with the COVID-19 pandemic, and as tough as it is to admit, it is probably real. But maybe…
New rule appears to be fraught with problems and challenges. In a provision glossed over by most, the 2021 Inpatient Prospective Payment System (IPPS) Final Rule introduced a requirement that all providers transmit all records to Quality Improvement Organizations (QIOs) via electronic means as of Oct. 1, 2020. As a…
September 30, 2020

News Alert: Congress Keeps Government Open

By Matthew Albright
Vote on the continuing resolution (CR) helps providers with Advanced Payments. The U.S. Senate passed a continuing resolution (CR) this evening, which will keep the federal government open through the middle of December. As the government’s fiscal year ends today (Wednesday) at midnight, the CR was passed just in time.…