This area of coding is not so easy. While most maternal deaths are preventable, the rate has been increasing in the United States since 2000. As a matter of fact,…
The CMS budget for fraud, waste and abuse has doubled in size from 2021 to 2022. Two years ago, the federal government created a plan to audit Medicare Advantage (MA) insurers more…
In the world of healthcare regulation, when it rains, it pours – but then occasionally, like last week, we get a drought. Last week, the Centers for Medicare & Medicaid…
CMS has proposed a new rule that would update the Medicare Physician Fee Schedule and seek more health equity and telehealth utilization among physicians. The proposed rule would establish a…
The billing Code 44 and the required UR process have become intertwined. Utilization review teams and physician advisors have the same goal as the Centers for Medicare & Medicaid Services…
Hospitals are advised to offer choice to patients in terms of nursing homes, home care agencies, long-term acute-care hospitals, and inpatient rehabilitation facilities. It has now been over 18 months…
On April 27, 2021, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule for the fiscal year (FY) 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS). The…
The Centers for Medicare & Medicaid Services (CMS) has provided some guidance within the “Medicare and Medicaid Programs Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency”…
As the coronavirus (COVID-19) continues to grip headlines from coast to coast, the Centers for Medicare & Medicaid Services and the U.S. government are working to assist state and local…
The new rule contains two key requirements—annual disclosure of prices and 300 “shoppable” items. Effective Jan. 1, 2019, the Centers for Medicare & Medicaid Services (CMS) required that hospitals publish…
CMS’s IMM sends mixed messages to providers. The Important Message from Medicare (IMM) has changed significantly in its latest reiteration, and the IMM now must be presented to both Medicare…
At the beginning of November, CMS finalized changes to its Medicare payment systems for 2020. Here's a rundown of noteworthy changes CMS made: 1. Included a site-neutral payment policy and…
The Centers for Medicare & Medicaid Services (CMS) issued a final rule on September 5, 2019, intended to address program integrity and vulnerability issues. The Office of the Inspector General…
Aiming to cut down on regulatory burdens and give more power to states, the Centers for Medicare & Medicaid Services is making notable changes to the Medicaid program, the biggest…
The Open Payments database needs to improve the accuracy, precision and consistency of some of its data to ensure doctor financial transparency and help consumers better use the information. That’s…
(Editor’s Note: Dr. Terri Lewis has been very critical of the CDC for not requiring data collection about chronicity or context of chronic disease. She has been discussing this issue…