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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…
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The federal agency has been churning out waivers and adjustments on a rolling basis during recent weeks. Another day, another set of Centers for Medicare & Medicaid Services (CMS) regulatory adjustments amid the continuing COVID-19 viral pandemic. But this one is a little different. The federal agency unveiled yet another…
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EDITOR’S NOTE: RACmonitor.com news asked Dr. Ronald Hirsch, vice president at R1 RCM, to summarize the latest from the Centers for Medicare & Medicaid Services (CMS) on covering costs for COVID-19 care. In response, Dr. Hirsch provided RACmonitor the following summary. When the first guidance on COVID-19 testing was released…
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340B Health president was a recent guest on Monitor Monday. The following are edited remarks of her presentation.  2019 was another very busy year for people involved in the 340B drug pricing program. And it marked the end of a remarkable decade of progress and challenges. One of the most…
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EDITOR’S NOTE: While presenting at the recent New England Healthcare Internal Auditors (NEHIA) annual conference in Connecticut, Knicole Emanuel encountered the recurring audit topic of positive airway device supplies or PAPs. The following is her report. Back in 2014 and 2015, then again in 2018, PAPs were the main area…
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The announcement covers OPPS, ASC regulations, and promises to ramp up competition among providers. In a move that sparked instant and intense reactions across the healthcare industry, the federal government on Friday introduced twin final rules it says constitute “historic steps” to increase price transparency and increase competition among the…
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Therapy hours could go down and depression to go up at SNFs. A depression diagnosis is often hard to make. Clinical depression can be demonstrated in many ways and requires the subjective findings of a clinician. Some clinically depressed individuals seem to withdraw, while others can become irritable or even…
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Protecting patient rights is one of the cornerstones of Medicare policy. As a doctor, I can assure you that I would rather patients concentrate on their health and not worry about whether their medical providers or their insurers are making decisions for them based on considerations that are not in…
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Medicare Advantage plans appear to be following their own rules. Many of the national Medicare Advantage (MA) plans are misusing commercial guidelines and making up their own rules, as they see fit, in order to avoid paying hospitals equitably for the care provided to their members. That was the assessment…
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Five areas of concern are noted by the author. In the first part of this series, we examined audit risks associated with observation claims. We should review what other risk areas providers might expect and why, as Recovery Audit Contractors (RACs) ramp up reviews again. According to Centers for Medicare…