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…
CMS recently finalized a rule that will shift the Medicare payment system for skilled nursing facilities (SNF) away from fee-for-service and toward value starting in 2019. The federal agency will…
It's been an open secret that the federal government has, for years, wanted to change long-term care's payment system from one rewarding volume of services to one that pays for…
CMS filed its annual Medicare inpatient payment update April 24, which would increase payments to hospitals next year and follow through on some of the administration's top healthcare promises, including…
(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…
(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. This is the first of a…
Medicaid improper payments, including fraud, have spiked in recent years, reaching $37 billion in 2017, according to a government watchdog agency. And the Centers for Medicare & Medicaid Services (CMS)…
On Nov. 2, CMS received the 2018 final payment rule, providing a 1.2 percent increase in ASC reimbursement next year. The final rule also addressed several issues pertaining to orthopedic…
New identification cards the government is sending out to all Medicare recipients in an effort to deter fraud may actually end up encouraging scammers and hindering physician billing, according to…
Over 20% of U.S. children live in a household without consistent access to food. To promote food security among all children and families, the Academy supports screening families using the…
Infections occasionally have a knack for developing resistance to treatment, and when that happens, costs add up, according to a new study published in Health Affairs. Resistance adds more than…
The departure of seven accountable care organizations from CMS' Next Generation ACO Model program will likely not threaten the viability of the program, but the reasons behind the early exit…
The Trump administration twice last week demonstrated its interest in simplifying the administrative burden of electronic health records (EHRs) for physicians. Separately, a major new study suggests these high-tech medical…
In the Medicare Advantage (MA) context, "risk adjustment" is the process by which the Centers for Medicare & Medicaid Services (CMS) reimburses Medicare Advantage Organizations (MAOs) based on demographic factors…
A new government report finds that Medicare improperly paid acute care hospitals for outpatient services they provided to patients who were inpatients at other facilities. And now Medicare wants the…
Changes are coming with Evaluation and Management (E&M) coding guidelines. I will use this space to explain why these changes will be both a good thing and a challenge to…