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In an unprecedented move, the Centers for Medicare & Medicaid Services (CMS) has released 15 documents specifying new waivers in response to the COVID-19 pandemic. These waivers touch every aspect of medical care. CMS Administrator Seema Verma said that while all the waivers are blanket waivers covering all providers in…
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Rural America is facing a healthcare crisis.   EDITOR’S NOTE: The global pandemic of the coronavirsus is further exacerbating the rural health crisis. This is the first in a series of reports on rural health. Rural Americans, on average, are six years older than their urban counterparts, and make up about…
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List of resources for front-line professionals. Everyone is coping with the new norm imposed by COVID-19, with those at risk for the social determinants of health (SDoH) facing even tougher challenges. This article offers a broad look at emerging resources for you and your populations. Passage of the federal Families…
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Testing a limited number of random people, we can reach conclusions within a certain probability. Statistical analysis is a funny thing. It turns out that you don’t need a lot of data to reach a conclusion. At the start of the play “Rosencrantz and Guildentstern are Dead,” the two main…
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Not all waivers are created equal. Last week’s article briefly discussed the Emergency Medical Treatment & Labor Act (EMTALA). Here is a more detailed discussion. The legal analysis here is among the more difficult I’ve worked on in recent times. My colleagues and I spent hours trying to be sure we had…
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Long-awaited and highly anticipated, providers hope other payers will follow suit. Healthcare insurer giant UnitedHealthcare (UHC) has announced that it will be suspending prior authorization requirements for post-acute settings through May 31, 2020, with the waiver applying to long-term care facilities (LTCFs), acute inpatient rehabilitation (AIR), and skilled nursing facilities…
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EDITOR’S NOTE: Dennis Jones is the Administrator of Patient Financial Services for Montefiore Nyack Hospital in Nyack, N.Y., about 20 miles north of New York City. During a guest appearance on Talk Ten Tuesdays this week, Jones outlined how the COVID-19 pandemic is hitting the metropolitan area as hard as…
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March 23, 2020---The Centers for Medicare & Medicaid Services  (CMS) has clarified its position on the use of swing beds, saying that swing beds can accept patients without a three-day inpatient stay. In a question and answer response to the issue, CMS stated the following: Q. Does waiving the requirement…
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The regulatory landscape is rapidly changing in the wake of the coronavirus. EDITOR’S NOTE: As with last week, RACmonitor asked Dr. Ronald Hirsch, vice president of R1 RCM, to summarize the most pertinent regulatory changes recently arising. The following is a transcript of his reporting today on Monitor Mondays. “First,…
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The uncomfortable truth about the coronavirus pandemic? A near-total and indefinite shutdown of American life is probably just the beginning.   EDITOR’S NOTE: Veteran RACmonitor and ICD10monitor Editor and Correspondent Mark Spivey has spent the last week with his wife at their home in Monmouth County, New Jersey, working remotely…