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

Medicare and Medicaid Services

CMS Adds Pilot Project Participants to Reduce Medicare Costs

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) has announced over 2,100 acute care hospitals, skilled nursing facilities, physician group practices, long-term care hospitals, inpatient rehabilitation facilities, and home health...

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...

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...

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...

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...

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...

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 RevCycleIntelligence.com article, Will Medicare Part D Prescription Drug Plans Stabilize, has...

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...

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...

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,...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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