Featured Article

For those for you who are regular listeners to Monitor Mondays, you heard Dr. Ronald Hirsch in his April 10 ”Monday Rounds” segment discuss an article recently published online by the Journal of Hospital Medicine detailing the appeal process of Recovery Audit Contractor (RAC) denials at three academic hospitals. I…
With a mission to improve rural healthcare access and outcomes for underserved populations through innovation and promising practices, the role of community health workers (CHWs) is rapidly evolving across rural areas, having been recognized by the U.S. Department of Labor as an essential part of the cost- effective delivery of…
April 12, 2017

Field Report: OIG Compliance Program Effectiveness Guide

By Nancy J. Beckley, MB, MBA, CHC
Indeed, it was another “Dantastic” Monday as Inspector General Dan Levinson took the podium to deliver the keynote at the 21st Annual Compliance Institute in National Harbor, Maryland.  Dan opened with the discussion of a January Health Care Compliance Association (HCCA) U.S. Department of Health and Human Services Office of…
I recently attended the Health Care Compliance Association’s (HCCA) Compliance Institute (March 25-29, 2017) in National Harbor, MD, where healthcare compliance experts gathered to discuss the challenges faced in today’s complex regulatory environment. From there, a short ride to Washington, D.C., took me to the annual HIPAA Summit (March 29-31,…
March 29, 2017

Making the Case for a Single-Payer System

By Howard Stein, DO, MHA, CHCQM-PHYSADV
EDITOR’S NOTE: As congressional Republicans and the Trump administration grapple with challenges associated with their efforts to repeal and replace the Patient Protection and Affordable Care Act, talk continues to swirl about the possibility of a single-payer healthcare system. In this exclusive story, Howard Stein offers his personal opinion in…
EDITOR’S NOTE:Matthew Albright will be the special guest on the March 27 edition of Monitor Mondays. Register now!This story was posted on Tuesday in the ICD10monitor e-News. Matthew Albright oversaw the certification program at the Center for Affordable Quality Healthcare (CAQH) and Committee on Operating Rules for Information Exchange (CORE)…
March 14, 2017

Tap into Your Contracting Office for Rules of the Status Games

By Juliet B. Ugarte Hopkins, MD, CHCQM-PHYADV
Since it was put into place back in 2013, most of us have managed to grasp the specifics of the Medicare two-midnight rule. Whether there was an anticipation of two midnights of medically necessary care in the hospital at the time of admission, or expectation of a second, medically necessary…
March 9, 2017

The Rising Tide of Small Scale Privacy Breaches

By Sara Goldstein, Esq.
Although small privacy breaches affecting less than 500 patients per incident are not usually broadcast as widely as large scale cyberattacks, they can be just as detrimental to healthcare organizations. These small breaches can be as simple as a patient’s protected health information (PHI) mistakenly going to the wrong person.…