COVID19 - RACmonitor

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By now we’ve all heard the words “anyone who wants a COVID test can have one.” Occasionally, that claim is followed by the word “free,” or “no copay or deductible.” Such statements make great news and sound bites, but it leaves people like me wondering: where’s the catch? Accepting a…
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During this week’s Monitor Mondays broadcast, Ronald Hirsch, MD, vice president at R1 RCM, reminded listeners how confusing all the waivers and flexibilities associated with the COVID-19 pandemic have been, while noting that what is more amazing is that the confusion hasn’t stopped. The latest confusion, Hirsch said, relates to…
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This article will explore Medicaid expansion during COVID-19. We all know that COVID has uprooted our lives. Telehealth is the new post-COVID norm, whereas it was in infancy pre-COVID. Perhaps the pandemic has spurred on Medicaid expansion as well. I would be remiss if I did not mention that increased…
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Over the course of the continuing COVID-19 pandemic, one topic has mysteriously fallen under the radar. It’s something that greatly impacts health outcomes, and especially virus transmission rates. The Joint Commission identified this issue in 2008 as among the most important factors to impact population health. Any ideas? One final…
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EDITOR’S NOTE: This article, originally published on RACmonitor and ICD10monitor, has been updated to alert facilities that COVID-19 testing inclusions will have a fiscal impact starting Sept. 1, 2020. Effective Sept. 1, the Centers for Medicare & Medicaid Services (CMS) has enlisted a mandate requiring hospitals to have positive COVID-19…
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As scary as it seems, COVID-19 continues to exacerbate the stark realities imposed by the social determinants of health (SDoH), racism, and health disparities. The story I’m reporting on this week is about as hard to fathom as the pandemic itself. Hospitals across the country are reporting that ICU beds…
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The CARES Act included provisions mandating reporting of test results. Federal officials announced a set of sweeping regulatory changes for nursing homes nationwide this week, an expected move considering the disproportionate impact the continuing COVID-19 pandemic has had on such facilities since its onset earlier this year. The Centers for…
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Program integrity at the Centers for Medicare & Medicaid Services (CMS) is under pressure to properly conduct Recovery Audit Contractor (RAC) and Medicare Administrative Contractor (MAC) audits during the ongoing public health emergency (PHE). Up high on the “to be audited” list is post-payment reviews of COVID-19 claims to confirm…
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And then there were 12: Medicaid expansion, COVID-19, and the SDoH Elections in Missouri last week moved that state into the expansion fold. Voters approved creating a state constitutional amendment opening Medicaid eligibility to healthy adults, as of July 2021. This win was a big one, given strong opposition from…
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The Centers for Medicare & Medicaid Services (CMS) in the past week has proposed Medicare payment rules for outpatient services and physicians for 2021 and finalized payment rules for inpatient rehabilitation facilities (IRFs) and psychiatric facilities.Looking specifically at the 2021 Physician Fee Schedule (PFS) proposed rule, scheduled to be published…