UnitedHealthcare recently transitioned its utilization management approach for all of its health plans from Milliman Care Guidelines to InterQual criteria. Learn how this change could have far-reaching impact on hospitals.
This week's note from the instructor discusses CMS' proposal in the CY 2022 OPPS proposed rule to reverse course on CY 2021 changes to the inpatient-only list and the ambulatory surgical center covered procedures list.
CMS walked back some major policy changes and cemented others in the 2022 Inpatient Prospective Payment System (IPPS) final rule. Brush up on the latest changes and ensure your hospital is ready to comply by October 1.
As the country sees a resurgence of COVID-19 thanks to the delta variant, hospitals are seeing an increase not only in their immediate census numbers, but also in the number of readmissions.
With the first month of fall arrived, it’s time to start thinking of the year ahead—and, of course, to finish the year strong. We’ve gathered some HIPAA compliance tips to consider while getting through the final third of the year and building some compliance momentum heading into 2022.
CMS has reinstated the short-stay reviews and high-weighted DRG reviews originally halted in 2019. The national contract to conduct these reviews was awarded to Livanta, one of the Beneficiary & Family-Centered Care and Quality Improvement Organizations.
