News & Analysis

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
Medicare Web

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

November 21, 2018
Medicare Web

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.  

November 19, 2018
Medicare Web

Q: What is the difference between the two types of Remittance Advice Remark Codes (RARC)?

November 14, 2018
HIM Briefings

Take a look at the appeal process from the perspective of a hospital that submitted a redetermination request after a claim for cataract surgery was reopened.

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