News

CMS clearly is honing-in on reducing administrative burden as changes go into effect.  On Friday, Nov. 1, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Physician Fee Schedule (MPFS) Final Rule for the 2020 calendar year. While the official Federal Register version won’t be available until Nov. 15,…
Biased health outcomes are revealed.  Poor and biased health outcomes related to health equity has been a recent theme across the healthcare industry, especially in relation to the social determinants of health (SDoH). New studies and consistent data reinforce the need for a shift in how the industry approaches general…
Final Rule covers a wide range of payment and other provisions. The Centers for Medicare & Medicaid Services (CMS) wrapped up last week by unveiling a final rule associated with the Medicare Physician Fee Schedule (MPFS) and new policies governing the functions of the payment systems for the Outpatient Prospective…
Both policy issues remain on the CMS agenda, even though the agency has lost two court battles. Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma was probably well aware of what she was walking into last week at the U.S. House of Representatives Energy and Commerce committee hearing.…
A preliminary injunction has been filed in federal courts to halt the termination of two dozen Virginia behavioral healthcare providers. There are some updates on the matter of A Village Youth and Family Services, Inc., et al v. The Commonwealth of Virginia et al, through which more than two dozen…
As advances in surgery continue, more and more procedures are destined for the outpatient arena. This year saw dramatic changes for ambulatory surgery centers (ASCs), with the release of the 2020 Outpatient Prospective Payment System (OPPS) Proposed Rule (CMS-1717-P) and the release of the final Regulatory Provisions to Promote Program…
Addressing SDoH from an acute care perspective.  “Non-compliant:” please, remove this from your lexicon. It’s a pejorative doing injustice to patients and providers alike.  “Barriers to adherence to a prescribed regimen” is a better descriptor. The behavior has context. Patients very often have obstacles to optimal wellness, some self-inflicted, some…
There are resources available to help prevent wrongdoers from successfully targeting vulnerable patient populations. A dirty little secret of the long-term care industry is that the problem of identity theft arises more often than is reported.  In all fraud, there is the fraud triangle. The triangle sides are pressure, opportunity,…