Case Management

If it’s true that no news is good news, then the 2024 Outpatient Prospective Payment System (OPPS) proposed rule should make case managers very happy.

Amanda, a surgical case manager, learns that her patient, Evan, lives in a region so remote that there are no home care services available.

Elizabeth Hogue, Esq., explains why it just got a little harder for the federal government to hold healthcare organizations liable under the False Claims Act.

In their HCPro book The Hospital Guide to Contemporary Case Management, authors Stefani Daniels, RN, MSNA, ACM, CMAC, and Tiffany Ferguson, LMSW, CMAC, ACM, examine a critical question that many organizations ask when they are looking to hire—does a case manager really need to be a registered nurse?

CMS recently released a list of the 43 drugs and biologicals with a lower coinsurance for 2023.

Debra, a case manager, helps a patient who has undergone plastic surgery six times in the past six years.

CMS introduced the inpatient-only list in 2001 to ensure patients who undergo complex, high-risk surgical procedures receive postoperative monitoring services in an inpatient setting.

Surveyors don’t always get it right. Learn how to contest deficiencies and get them reversed.

Research has shown that high drug costs can have a substantial effect on patient care. Learn how these costs can impact skilled nursing facility (SNF) admissions.

Joanna, a case manager, provides support to a 19-year-old subway accident victim.