News

June 8, 2018 is the deadline for participation. Like watching the sunset approach the horizon, time is running out for hospitals and health systems weighing their participation in new initiatives being offered by the Office of Medicare Hearings and Appeals (OMHA) to settle backlogged claims at the Administrative Law Judge…
Many healthcare professionals have unwittingly placed their facilities at risk for ransomware attacks. Many of us watched Mark Zuckerberg testify before Congress last week, in the wake of the news that Facebook had released the data of 87 million users to a company named Cambridge Analytica, which in turn sold…
She had chosen palliative care as the medical therapy. EDITOR’S NOTE: Former First Lady Barbara Bush died Tuesday at age 92 at her home in Houston, having decided to decline further medical treatment for health problems and instead to focus on “comfort care.” The ‘Great Man Theory’ of history was…
The latest and greatest in Medicaid news, state by state. While Medicare is a nationwide healthcare insurance program, Medicaid, the government-funded health insurance for the poor and developmentally disabled, is state-specific, generally speaking. The backbone of Medicaid is federal; federal regulations set forth the minimum requirements that states must follow.…
Not all P2Ps should be pursued. In my reporting a few weeks ago, I encouraged physician advisors and other leaders in case management to analyze the outcomes of their peer-to-peers (P2Ps). As a reminder, P2P conversations revolve around the appropriateness of Inpatient status and take place between the medical director…
CMS does not specify effective date for new changes. The Centers for Medicare and Medicaid Services (CMS) has published a decision memo for Magnetic Resonance Imaging (MRI). The decision memo, posted on Tuesday by CMS, reviewed the proposed updates to the National Coverage Determination (NCD) 220.2 (C )(1) and 220.2…
Don’t confuse your payer policy with providers’ medical degrees My recent article regarding secondary diagnosis coding and my advice to “just follow the guidelines” seems to have touched a nerve. Because it’s never quite that simple, is it? There’s the textbook answer on how we should be coding, and then there’s…
Don’t count on headlines; reading the fine print is crucial. Recently I presented a RACuniversity webcast on the changes to the National Coverage Determination (NCD) for automatic implantable cardioverter defibrillators (ICD), the MitraClip, and more. If you missed it, you can still watch it on demand. There are a couple…