News & Analysis

April 1, 2013
Strategies for Healthcare Compliance

St. Joseph's Medical Center in Towson, Md., reached a settlement with the United States to pay $4.9 million in connection with its submission of false claims to Medicare, Medicaid, and other federal healthcare programs, announced the Justice Department on February 7.

April 1, 2013
Strategies for Healthcare Compliance

There has been some confusion surrounding a possible Recovery Auditor-related provision in the American Taxpayer Relief Act of 2012, also known as the fiscal cliff deal.

April 1, 2013
Briefings on APCs

CMS is making a significant change to the Medically Unlikely Edits (MUE) by changing some of them from line-item edits to date-of-service (DOS) edits, effective April 1.

April 1, 2013
Briefings on APCs

Editor's note: Facilities need to address coding, payment, and coverage issues for molecular pathology. This article is the first in a series and discusses molecular pathology coding.

April 1, 2013
Briefings on APCs

Being audited is rarely fun. After all, you're probably going to lose money, face a fine, or both. More and more entities are auditing healthcare claims-Recovery Auditors, Medicare Integrity Contractors, MACs, FIs, commercial payers, and on and on.

March 1, 2013
Case Management Monthly

When patients leave the hospital, one key factor often determines whether they'll soon need to be readmitted: how well they follow their discharge instructions.

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