News & Analysis

November 1, 2017
Briefings on APCs

Section 216(a) of the Protecting Access to Medicare Act of 2014 (PAMA) added a requirement that will dramatically revise the Medicare Clinical Laboratory Fee Schedule (CLFS) effective January 1, 2018.

October 4, 2017
Medicare Web

In fiscal year 2016, 65% of providers were subject to prepayment review associated with the CMS Fraud Prevention System, according to a report by the United States Government Accountability Office (GAO).

October 4, 2017
HIM Briefings

Outsourcing some HIM functions is common at many organizations. The decision might initially be spurred by staffing shortages or budgetary concerns, but many outsourcing arrangements become long-term projects. 

September 28, 2017
Medicare Insider

This week's note reviews a recent Office of Inspector General report that found a 100% failure rate among reviewed claims. 

September 1, 2017
Briefings on APCs

In the 2018 OPPS proposed rule, CMS proposed a change to the current clinical laboratory date-of-service policies for molecular pathology tests and for Advanced Diagnostic Laboratory Tests.

August 16, 2017
HIM Briefings

The specificity of ICD-10 ushered in a stronger focus on clinical coding audits. From internal reviews to external coding audits, healthcare organizations nationwide are revisiting tried-and-true audit practices with ICD-10 coding quality in mind.

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