Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Medicare and Medicaid Services

CMS Extends Upcoming Two-Midnight Partial Enforcement Delay

by Jacqueline DiChiara

The partial enforcement delay of the two-midnight policy originally set for September 30, 2015 expiration has been extended by the Centers for Medicare & Medicaid Services (CMS) through December 31, 2015, confirms the American Hospital...

Does Improved Care Access, Insurance Coverage Stem from ACA?

by Jacqueline DiChiara

Can the Affordable Care Act (ACA) be considered a success? According to data analysis published in The Journal of the American Medical Association, the answer is a hearty yes. Although the time prior to the ACA’s initial enrollment period...

Will CMS Proposed Stark Law Revisions Bring Doctors Relief?

by Jacqueline DiChiara

The Centers for Medicare and Medicaid Services (CMS) recently published proposed revisions to the Stark Law – a key piece of healthcare regulation involving physician self-referral regulations. As penalties and sanctions involving...

CRE Backs Reform Process of CMS Hospital Star Ratings System

by Jacqueline DiChiara

Is the Hospital Quality Star Ratings system released by the Center for Medicare & Medicaid Services (CMS) merely too problematic to be effective? According to the Center for Regulatory Effectiveness (CRE), the program’s overall design...

CMS Announces Final Rule Implementing Quality Care in SNFs

by Sara Heath

Value-based payment and quality care continue to prove high on the Centers for Medicare & Medicaid Services’ (CMS) agenda. On July 30, the Centers for Medicare & Medicaid Services (CMS) announced their final rules for the fiscal...

Medicare, Affordable Care Act Spending Discussion Continues

by Jacqueline DiChiara

Medicare and the Affordable Care Act's (ACA) financial future is perhaps nothing more than a cyclone of ever-evolving opinions. A recent article, Will Medicare Part D Prescription Drug Plans Stabilize, has been...

Healthcare Reform Bill to Financially Support Mental Illness

by Sara Heath

Lack of mental health care causes major financial issues, costing approximately $193 billion in lost earnings and productivity, according to a recent new release. On August 4, Senators Bill Cassidy, MD, of Louisiana and Chris Murphy of Connecticut...

Healthcare Spending to Rise Despite Lack of Patient Input

by Sara Heath

Healthcare spending is expected to climb to enormous heights by 2024, according to a recent news release by the Citizen’s Council for Health Freedom (CCHF). According to Twila Brase, R.N and Co-Founder and President of CCHF, these rising...

CMS, Rhode Island Announce New Medicare-Medicaid Care Model

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) announced a partnering with the state of Rhode Island last Thursday to test a new model for supporting Medicare-Medicaid enrollees by advocating for a more harmoniously executed, people-focused...

SNFs to Receive Funds Via Proposed Rural Healthcare Bill

by Sara Heath

New legislation may be able to alleviate the healthcare and Medicare costs that have for so long caused issues regarding access to care in rural areas. Skilled nursing facilities (SNFs) may see an increase in funding thanks to a proposed bill...

CMS Revises ICD-10 FAQ List for Billable Code Clarification

by Sara Heath

Following the July 27 issued ICD-10 frequently asked questions list, the Centers for Medicare & Medicaid Services (CMS) has updated some of the information. These updates primarily clear up confusion regarding family codes and what qualifies...

4,000 Healthcare Providers Receive $54M for HEDIS Excellence

by Jacqueline DiChiara

Physicians are demonstrating their continued dedication to advancing the quality of healthcare and helping Medicare Advantage members receive optimum treatment and are getting paid accordingly for doing so. UnitedHealthcare recently distributed...

4 Triumphs and Challenges in Medicare and Medicaid’s 50 Years

by Sara Heath

After 50 years as laws, Medicare and Medicaid have seen several triumphs and challenges, making their marks on American healthcare from expanding low-income coverage to raising serious questions about national finances.. As Medicare and Medicaid...

July 31: Week That Was in Healthcare Fraud and Malpractice

by Jacqueline DiChiara

Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice and the Office of Inspector General. The crimes reported below result in multiple millions of dollars...

Will Medicare Part D Prescription Drug Plans Stabilize?

by Jacqueline DiChiara

As Medicare – established along with Medicaid on July 30, 1965 – formally hits its 5-decade anniversary this week, the healthcare industry turns over a new financial leaf upon considering where new spending and saving focuses...

How Can Hospitals Refocus Cost Reduction, Payment Tactics?

by Jacqueline DiChiara

As hospitals consider various ways to strengthen their revenue cycle, they may be focusing on the wrong places while overlooking the right places. As the expansion of hospital acquisition and mergers continues with more vigor, healthcare costs...

NOTICE Act Helps Beneficiaries Understand Healthcare Costs

by Sara Heath

In a unanimous vote, the Senate passed the Notice of Observation Treatment and Implication for Care Eligibility Act (the NOTICE Act) on July 27, according to the American Hospital Association (AHA). On July 29, the bill was presented to...

Is Sustainability the Future of Healthcare Spending Growth?

by Jacqueline DiChiara

Healthcare spending growth is expected to increase throughout the next decade, according to newly released data from Health Affairs via the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary (OACT). Are future surmised numbers...

CMS Releases New Medicaid Enrollment, Medicare Coverage Data

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) has released updated Medicare state-by-state enrollment numbers. Over 55 million individuals are covered via Medicare, says CMS. This number is 36 million greater than nearly 50 years ago...

NAMD Says Medicaid Managed Care Rule Restricts Healthcare Reform

by Sara Heath

In response to the proposed regulations of Medicaid managed care, the National Association of Medicaid Directors (NAMD) submitted a list of comments to the Centers for Medicare & Medicaid Services (CMS), according to a statement made by Matt...


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