Medicare news

While Medicare Advantage (MA) plans may be an appealing, potentially lower-cost option for patients, they’ve created big hassles for case managers.

Peggy Rossi, BSN, MPA, CCM, CM/RN, CMAC, discusses workplace violence prevention in the healthcare industry and provides tips for training and education. 

Review what case managers should know about the new mandatory episode-based payment model approved by CMS in the 2025 Inpatient Prospective Payment System (IPPS) final rule.

The American Hospital Association (AHA) recently urged Congress to pass stalled bipartisan legislation that would help protect healthcare workers from violence.

Case managers should familiarize themselves with CMS' behavioral health policies to ensure they continue to provide high-quality patient care.

Familiarize yourself with the new ICD-10-PCS code set for fiscal year (FY) 2025 before it takes effect on October 1. 

Unpack the 2025 Outpatient Prospective Payment System (OPPS) proposed rule to see what adjustments could be in store for case managers.

Review updates in the 2025 Medicare Advantage (MA) and Part D final rule that could impact case management practices.

A recent case illustrates the risks that organizations face when they fail to protect healthcare workers from violence.

Kepro recently updated its discharge appeal process, bringing with it more work and new questions for case managers.