News

The role has grown in both importance and stature. Back in 2012, Elizabeth Lamkin, MHA, now chief operating officer for the American College of physician advisors (ACPA), wrote an article for RACmonitor titled, “Need a Silver Bullet? Try Adding a physician advisor.” Six years later, speeding toward 2019, that idea…
Medicare patients were specifically excluded from the program. The U.S. Justice Department announced on Dec. 6 that Actelion Pharmaceuticals has agreed to pay $360 million to resolve allegations that it paid kickbacks by giving contributions to the Caring Voice Coalition, a charitable organization that then used the contributions to pay…
2018 Hirsch’s Heroes Announced. It has been my honor over the last few years to take a moment each winter holiday season to recognize people who I think have made a difference over the previous year. It is not easy, deciding. So many people work hard every day doing the…
States could play a role in expediting its approval as a therapy. Sixty-two percent of Americans reportedly support legalization of cannabis. Thirty-one states allow medical marijuana and nine states have sanctioned recreational use. Cannabis is a very old medicine. Archeological evidence shows it was used 4,200 years ago in China.…
Recent issues in Oklahoma, Nebraska portend a growing crisis. The news coming out of Oklahoma was grim: Pauls Valley Regional Medical Center couldn’t keep its doors open, despite a GoFundMe campaign, as well as a reported solicitation from country music star Toby Keith. And in September, Latimer County General Hospital,…
100% error rate audits challenge credibility. Over the past five or six years, I have worked as a statistical expert on hundreds of extrapolation audits. And at least a couple dozen of these were based on 100 percent error rates. That means that the auditor determined that, of all of…
Provider-based facilities may share space with a freestanding entity. Any provider that has an arrangement under which there is a freestanding clinic in a building that also contains provider-based or hospital space needs to understand both the relevant Centers for Medicare & Medicaid Services (CMS) policy and the law related…
Proposed changes will impact hospitals, critical access hospitals, inpatient rehabilitation facilities, and home health agencies. The Centers for Medicare & Medicaid Services (CMS) back in 2015 proposed changes to the Conditions of Participation (CoP) found in 42 CFR part 482. The rationale for the changes is provided in elegant detail…