News & Analysis

July 1, 2021
Case Management Monthly

CMS announced another round of changes to its Bundled Payments for Care Improvement program recently and said that while participation thus far has been voluntary, it may become mandatory starting as early as 2024.

July 1, 2021
Case Management Monthly

A policy that UnitedHealthcare was poised to roll out that would have allowed it to retroactively deny ED claims isn’t moving forward yet. But that doesn’t mean case managers shouldn’t prepare for the payer, or others, to implement such policies.

June 1, 2021
Case Management Monthly

Ensuring patients are being treated with the right level of care helps facilities allocate resources appropriately and keeps costs lower for patients and health systems.

May 1, 2021
Case Management Monthly

Inpatient or observation? Making this decision remains a considerable challenge at many hospitals—and when they get it wrong, it can also be a costly one.

January 4, 2021
Medicare Web

Q: Are procedures removed from the inpatient-only (IPO) list in 2021 subject to the 2-midnight rule?

November 18, 2020
Medicare Web

The Office of Inspector General (OIG) is planning to audit hospital inpatient claims for compliance with the 2-midnight rule, according to a recent update to its Work Plan.

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