MedPAC, the advisory commission to Congress for Medicare, presented its evaluation of the Medicare Hospital Readmission Reduction Program (HRRP) at the September meeting. The HRRP was enacted in 2010. In […]
Recently, I came across an OIG announcement “Review of Medicare Part B Claims for Intravitreal Injections of Eylea and Lucentis” released in June 2019. Upon reading this announcement, I pulled […]
In her article, Kelly Long, CPC, discusses the importance of accurate and compliant physician assistant reimbursement.
Patients are charged around $1,200 for an ambulance ride to the hospital, while the median price of an air ambulance for privately insured patients is $36,400. Why is the price […]
McAllen, Texas is a border town in the Rio Grande Valley with a metro population of 839,000. On May 25, 2009, Atul Gawande published The Cost Conundrum in which he […]
On October 3rd, 2018 Medicare announced significant changes to the Local Coverage Determination (LCD) process. As a result, a major change to the LCD format was also announced in Change […]
The new year is upon us: Are you ready for the 2019 Value-Based Purchasing Program? Eric Sorenson and Cheryl Manchenton will help you get up to speed.
When it comes to reducing Hospital Associated Infections (HAIs), where should your organization focus its efforts?
On February 9, a new telehealth bill was signed into law that expands coverage for accountable care organizations (ACOs), improves flexibility for telehealth use under Medicare Advantage plans, and allows […]
Recently, I reviewed the Medicare Hospital Value-Based Purchasing (VBP) scores for three hospitals recognized nationally for outstanding care and patient safety. They didn’t look good. The ratings for clinical outcomes […]
I attended the January 9, 2018 CMS Medicare Learning Network conference call covering the logistics of the settlement process offered by CMS for providers with pending appeals. This impacts: “The […]
L. Gordon Moore and Donna Smith discuss how appropriate documentation and coding of hierarchical condition categories (HCCs) can have a significant impact on payment in a value-based system.