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

Policy & Regulation News

December 11: Week That Was in Healthcare Fraud and Malpractice

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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 (OIG). The crimes reported below result in multiple millions of...

Why Patient Advocacy is the New Future of Healthcare Reform

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There is power in numbers, especially when it comes to healthcare reform. A group of 9 major patient advocacy groups – AIDS United, American Liver Foundation, Amputee Coalition, the Christopher & Dana Reeve Foundation, Hemophilia Federation...

How to Sustainably Bend the Cadillac Tax Cost Curve

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The Cadillac of healthcare coverage is the talk of the healthcare industry as 2016 draws nearer. The United States Senate recently voted 90-10 to repeal the Cadillac Tax – a 40 percent excise tax and Affordable Care Act component...

Physicians List Top 5 Value-Based Payment Success Factors

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Physicians say lack of time is one of the leading obstacles they face regarding value-based care delivery, according to a study from the American Academy of Family Physicians (AAFP). One-third of family physicians are actively pursuing value-based...

Is Increased Medicaid Coverage the Chronic Disease Solution?

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What do Manhattan rents, Ferraris, college tuition, and chronic disease all have in common? They are all really expensive. What is especially problematic is that chronic diseases are not only very costly, but also very common within the healthcare...

Senate Votes to Repeal Affordable Care Act, Reactions Ensue

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The United States Senate voted 52-47 last night in support of the Restoring Americans’ Healthcare Freedom Reconciliation Act (H.R. 3762.) This bill, which repeals segments of the Affordable Care Act, apparently slashes the Planned...

December 4: Week That Was in Healthcare Fraud and Malpractice

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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 (OIG). The crimes reported below result in multiple millions of...

Is It Too Soon to Gauge ICD-10’s Long-Term Coding Future?

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Regarding the future of revenue cycle management and ICD-10 implementation, is it merely too soon to tell what the long-term future of coding, laterality challenges, and documentation snafus holds? If so, what exactly comes next other than an...

CMS Confirms More Affordable 2016 Medicare Part B Premiums

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Healthcare consumers’ wallets will apparently be a tad fuller next year. 2016 will not see a cost of living increase for those under Social Security, according to an announcement from the Centers for Medicare & Medicaid Services...

CMS Announces Two-Midnight Payment Cut Commentary Period

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A notice and accompanying commentary period released yesterday from The Centers for Medicare & Medicaid Services (CMS) examines the core issue behind slashing hospital inpatient payments by 0.2 percent. This financial cut is tied to a “two-midnight...

CMS Reports $2.4B in Healthcare Consumer ACA Premium Rebates

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Consumers are apparently receiving major bang for their buck, although not in relation to this week’s hard-to-miss Black Friday and Cyber Monday holiday sales brouhaha. Healthcare consumers have received over $2.4 billion premium rebates...

CMS Approves Outpatient Ambulatory Patient Experience Survey

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How can you best measure patient experience? Perhaps with a 37-question survey. The Centers for Medicare & Medicaid Services (CMS) has approved the administration of an Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare...

Why ICD-10 Denial is an Easy Electronic Health Record Fix

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Did Electronic Health Records (EHRs) save the healthcare industry from massive post-ICD-10 implementation claims denial? The healthcare industry will not have a confident grasp about tangible payment process success until Thanksgiving, said Joshua...

CMS Announces Top 3 Volume to Value Medicare Payment Goals

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Patrick Conway, MD, MSc, Chief Medical Officer at the Centers for Medicare & Medicaid Services (CMS), is speaking out about the administration’s overarching goals for Medicare’s future. In yesterday’s blog post,...

Nov. 20: Week That Was in Healthcare Fraud and Malpractice

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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...

Senate Committee Approves Rural Health Care Connectivity Act

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Those living in rural areas of the country without a hospital delivering affordable care nearby may soon be at ease due to passage of a new bipartisan bill. United States Senator John Thune (R-SD), Chairman of the Senate Committee on Commerce,...

Is Data Collection too Burdensome in CMS Final Payment Rule?

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A new 311 page final rule from the Centers for Medicare & Medicare Services (CMS) aims to amend the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system. CMS’s...

Why are Incorrect Characters a Top ICD-10 Coding Challenge?

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Lack of training for inpatient procedural coding may pose a significant challenge for the healthcare industry as 2015 comes to a close, said Teri Jorwic, ICD-10 Educator and Professor of Healthcare Informatics at the University of Illinois at...

ICD-10 Mid-November Advice: Focus on Coding, EMRs, and KPIs

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The healthcare world did not necessarily end with the ICD-10 switchover. Over 4.6 million daily claims throughout the month of October were reportedly processed with a 10 percent denial rate; 13 million claims were said to...

Public Health Funding for Disease Prevention Drops by $40B

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Per capita health spending has dropped by over $40 billion from 2009 to 2014, confirm researchers David U. Himmelstein, MD, Lecturer at Harvard Medical School and Professor at the City University of New York (CUNY), and Steffie Woolhandler, MD,...

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