News & Analysis

September 1, 2021
Case Management Monthly

Audits are ramping up across the country, creating additional headaches for many healthcare organizations as they simultaneously struggle with the delta variant of COVID-19.

August 4, 2020
Medicare Web

Facing the unprecedented COVID-19 public health emergency, CMS released the 2021 OPPS proposed rule later than ever before, with the agency generally reinforcing its recent focus on site-neutral payment policies, lowering reimbursement for drugs purchased under the 340B program, and adding more services to the list of prior authorization. 

January 22, 2020
HIM Briefings

Conflicting provider documentation can raise red flags for auditors and slow down coding. Learn about common causes of conflicting documentation and strategies to reduce its occurrence.

October 1, 2019
Briefings on APCs

As Medicare Advantage makes strides to becoming the new norm, organizations need to establish new processes, educate staff, and advocate for patients. Learn how your organization can keep pace with change before it’s too late to catch up.

May 15, 2019
Medicare Web

HHS failed to meet targeted improper payment reductions for Medicaid and the Children’s Health Insurance Program and has not implemented a required recovery audit plan for Medicare Advantage, according to an Office of Inspector General (OIG) report.

December 1, 2018
Briefings on APCs

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