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

Medicare and Medicaid Services

June 12: 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...

CMS Explores ICD-10 Scenarios with Interactive Case Studies

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) has released a series of interactive case studies intended to enhance and advance the healthcare industry’s collective ICD-10 documentation comprehension. The ICD-10 countdown is formally...

AMA Inaugurates Stack, Youngest President in 160 Year History

by Jacqueline DiChiara

Steven J. Stack, MD, has been sworn in as the youngest president of the American Medical Association (AMA) within the past 160 years. Stack is the 170th president of the AMA, the nation’s largest physician organization. "I am...

June 5: 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...

CMS Shares $62B in Medicare Payment Data, Doctor Utilization

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) announced the third annual release of its Medicare hospital utilization and payment data at this week's annual Health Datapalooza conference in Washington, DC. CMS confirms this...

ACA Adds Billions in Bureaucratic Waste, Administrative Costs

by Jacqueline DiChiara

The Affordable Care Act (ACA) will prove a tremendous financial burden to the healthcare industry. Although the administrative costs of healthcare are projected to remain high throughout 2022, the ACA only promotes billions of dollars...

CMS Addresses Provider, Beneficiary Medicaid Payment Fraud

by Jacqueline DiChiara

Is Medicaid in danger as a high-risk program? Thousands of Medicaid beneficiaries and hundreds of healthcare providers are connected to allegedly erroneous or fraudulent payments, according to a recent US Government Accountability...

May 29: 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...

CMS Proposed Rule Modernizes CHIP and Medicaid Managed Care

by Jacqueline DiChiara

Following a recent series of proposed physician fee schedules and payment rules from the Centers for Medicare & Medicaid Services (CMS), a new proposed rule, CMS-2390-P, aims to modernize Medicaid managed care policies to mirror changes within...

CMS’s Transparency Gaps Yield Invalid Medicare Payment Rates

by Jacqueline DiChiara

The overall accuracy of Medicare payment rates significantly impacts the collective healthcare system. Medicare payment rate haste makes waste. Improved data and transparency efforts will dramatically improve accuracy within the healthcare...

May 22: 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 a $1B Investment Resuscitate Rural Hospitals, Doctors?

by Jacqueline DiChiara

Imagine only one healthcare provider serving an entire state. Such a concept is a stunning concrete fact. Critical Access Hospitals (CAHs) depending on location, such as the smallest state of Rhode Island, may have only 10 or fewer patients...

How Providers Can Avoid 2016 Medicare Payment Adjustments

by Jacqueline DiChiara

On January 1, 2016, payment adjustments will begin for those Medicare eligible professionals not participating in 2014's Medicare Electronic Health Records (EHR) Incentive Program, confirms the Centers for Medicare & Medicaid Services...

Spending Advances Medicaid with Transparency, Accountability

by Jacqueline DiChiara

The US Government Accountability Office (GAO) has released a report reviewing approved expenditure authorities within section 1115 of the Social Security Act. This segment of the Social Security Act allows the Secretary of the Department...

GAO Urges CMS Review Incomplete, Inaccurate Medicaid Payments

by Jacqueline DiChiara

Ensuring actionable results via the interpretation of cached information about Medicaid provider payments is not always a simple task. Although it is possible even severely flawed payment information can offer some sort of a general baseline...

$6.9B in Medicare Expenditures for Mental Health Care Costs

by Jacqueline DiChiara

Many individuals receiving care under the Medicaid umbrella lack insurance protection regarding mental health expenditures. A limitation of such coverage was lifted via the implementation of Mental Health Parity and Addiction...

Independent Payment Advisory Board Threatens Medicare Costs

by Jacqueline DiChiara

There are new Medicare cost concerns within the healthcare industry. Hundreds of healthcare organizations are actively voicing concerns to Congress about financial threats to private sector consumers and a possible watering down of industry-wide...

$200M Estimated Payment Increase for Medicare Hospices

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) has recently released a steady stream of proposed Medicare physician fee schedules and payment policies. As an addendum to last week’s RevCycleIntelligence.com summary of top six proposed...

Pioneer ACO Model: The Embrace of Population-Based Payments

by Jacqueline DiChiara

The Department of Health and Human Services (HHS) has released an independent evaluation report revealing an innovative patient care payment model. This model, the Pioneer ACO Model, which stemmed from a pilot project and Affordable Care Act...

Does Medicare Part D Prescriber Data Improve Transparency?

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) has announced the availability of updated privacy-protected data on Medicare Part D prescription drugs. The presented data explains which prescription drugs were prescribed to Medicare...

Continue to site...