News

New studies address health disparities and severity of COVID. Several major studies continue to advance the impact of health disparities and challenge the industry in how best to mitigate the ever-growing chasm. Research from Epic Health Research Network and the Kaiser Family Foundation validate that patients of color experience COVID-19 at concerningly…
LOS is often used to gauge hospital efficiency. When the Inpatient Prospective Payment System (IPPS) was introduced by the Centers for Medicare & Medicaid Services (CMS) back in 1983, hospital executives accepted the thinking that if Medicare is paying the hospital a set fee based on an expected length of…
EDITOR’S NOTE: Lisa Banker, MD contributed to the following report. Medicare Advantage Organizations (MAOs) were warned by federal health officials last week to issue an appealable organization determination when denying or recouping part or all of a payment from a non-contracted provider. The directive came in the form of a Centers…
September 24, 2020

Mixed Federal Messaging on COVID

By Matthew Albright
Congress appears to be closer on a COVID-19 relief package. U.S. Supreme Court Associate Justice Ruth Bader Ginsburg passed away on Friday. Ginsburg was the second woman appointed to the Supreme Court, serving there for 27 years. We mourn her loss, and as a country, we are grateful for her…
Food insecurity is on the rise. Amid the perils of the continuing COVID-19 pandemic are now growing concerns about food shortages around the country. Since COVID began, the U.S. Census has been tracking the impact of the associated economic crisis on the public. The numbers are important for healthcare organizations…
Medicare audits expected soon.Federal healthcare audits have resumed, and they are not limited to durable medical equipment (DME) or any one specific group of providers, any one type of contractor, or any one specific locality in the country. Since the announcement of the ramping up by the Centers for Medicare…
Your data will determine the overall success of your denial prevention and management efforts. No matter how robust the clinical documentation integrity (CDI) program, there are still payer denials. Payer audits become more creative and voluminous each day. Just when we think we have a handle on the top clinical…
September 22, 2020

News Alert: CMS Orders Halt to Loan Repayment

By Terry Fletcher, BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, CMCS, ACS-CA, SCP-CA, QMGC, QMCRC
Action applies to the Medicare Accelerated and Advanced Payment Loan Program.  In March, the Centers for Medicare & Medicaid Services (CMS) expanded the Accelerated and Advanced Payment Program (AAP) due to the COVID-19 public health emergency (PHE), in an effort to increase cash flow to providers. Under the current terms, repayment for…