News & Analysis

December 1, 2018
Briefings on APCs

Follow the steps a hospital should consider when submitting a redetermination request to a Recovery Auditor.

December 1, 2018
Briefings on APCs

Along with E/M changes for 2019 and beyond, the 2019 Medicare Physician Fee Schedule final rule contains a plethora of regulations impacting reimbursement, including new modifiers for therapists.

December 1, 2018
Briefings on APCs

Despite facing potential lawsuits and political opposition, CMS finalized some of its most controversial proposals in the 2019 OPPS final rule by implementing several site-neutral payment policies and 340B drug payment reductions.

November 26, 2018
News & Insights

Q: How do we manage Medically Unlikely Edits (MUE) on clinical trial claims?

November 21, 2018
News & Insights

Novitas Solutions, Inc. plans to pursue $7.2 million in intensity-modulated radiation therapy (IMRT) overpayments to hospitals in its jurisdiction, according to an Office of Inspector General report.

November 21, 2018
Medicare Insider

This week’s Medicare updates include new additions to the OIG Work Plan, transmittals on implementation of the End-Stage Renal Disease Prospective Payment System (PPS) and Home Health PPS, and a Special Edition MLN Matters article on waivers to assist with wildfire relief in California.  

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