Ninety percent of hospital and inpatient organization leaders are considering outsourcing both clinical and non-clinical functions to achieve cost-efficiencies and succeed in value-based care models, according to a recent Black Book survey.
Medicare made $54.4 million in improper payments to acute care hospitals for post-acute transfers that did not comply with Medicare’s policies, according to a recent report from the Office of Inspector General (OIG).
A new ICD-10-CM code for reporting vaping-related disorders will become effective April 1, 2020, the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics announced on December 9.
Safety-net hospitals may not have adequate resources to comply with federal and state sepsis quality improvement standards required of acute care hospitals, according to a recent study published in the Journal of Critical Care .
In the 2020 Medicare Physician Fee Schedule final rule, CMS proposes to adopt four new time-based HCPCS codes to be used in place of existing CPT codes for complex and non-complex chronic care management (CCM) services.
In the 2020 Medicare Physician Fee Schedule final rule, CMS increased the performance threshold for Merit-based Incentive Payment System (MIPS) eligible providers and finalized its proposal to implement the MIPS Value Pathways (MVP) framework in calendar year 2021.
CMS released the calendar year (CY) 2020 Medicare Physician Fee Schedule and OPPS final rules approving changes to E/M documentation guidelines, introducing new HCPCS codes, and continuing its potentially unlawful payment policy for drugs purchased through the 340B drug discount program.
The Centers for Disease Control and Prevention (CDC) recently released documentation guidance for providers who evaluate patients with symptoms of e-cigarette- or vaping-associated lung injury, as well as official ICD-10-CM coding guidance for reporting these encounters.
During the September ICD-10-CM Coordination and Maintenance Committee meeting, the Centers for Disease Control and Prevention (CDC) released a proposal to add, delete, and revise various ICD-10-CM codes for reporting sepsis.
The American Hospital Association, Community Oncology Alliance, and other hospital organizations expressed concerns regarding CMS’ proposed mandatory payment model for radiation oncology (RO), which if finalized, would go into effect January 1.
U.S. District Judge Rosemary M. Collyer recently ruled that CMS exceeded its authority when it expanded a site-neutral payment policy that cut reimbursement for certain E/M services provided in previously excepted off-campus hospital clinics.
In August, U.S. District Judge David Ezra in Texas dismissed a case against Baylor Scott & White Health that alleged the organization falsely billed for millions in false claims for Medicare reimbursement.
In response to a formal request for information from industry stakeholders, CMS received 567 comments on ways to improve its Patients Over Paperwork Initiative, including many requests from hospital groups to simplify billing and prior approval requirements.
CMS released the FY 2020 IPPS final rule on August 2, which finalized its decision on requests for new MS-DRG designations for chimeric antigen receptor T-cell (CAR-T) therapies. Upheld from the proposed rule, CMS denied these requests.