News

The Office of the National Coordinator for Health Information Technology (ONC) and the Office for Civil Rights released version 3.1 of the HHS Security Risk Assessment (SRA) Tool, designed to help healthcare providers conduct security risk assessments.

CMS is moving forward with multiple policies—effectively based on reducing reimbursement to hospitals—that have been deemed unlawful in court, according to the 2020 OPPS final rule, released Friday, November 1. However, the agency pushed its controversial price transparency proposals to a separate, yet-to-be released final rule.

Q: How should we handle denied claims when the payer refuses payment under the billed status? Do we need to document that the status was changed only because the payer did not agree to any other options?

Q: How do we bill for items provided to a patient participating in a clinical trial that are not listed on the billing intention?

Q: Is there ever a case in which, even with end-to-end encryption in place, you could still have breach notification requirements?

Chimeric antigen receptor T-cell (CAR-T) therapy provided to Medicare Advantage (MA) beneficiaries will be paid for by traditional Medicare for calendar years 2019 and 2020.

Q: What is considered the most significant social determinant of health?

Kalispell Regional Healthcare (KRH) in Montana recently announced an email data breach that may have exposed the protected heath information of nearly 130,000 of its patients.

Q: Are services provided at physician offices owned by our hospital subject to the three-day payment window?

The 2020 IPPS final rule introduced several MS-DRG changes within Major Diagnostic Category 8, effective October 1, which could affect reimbursement for certain orthopedic infections, neuromuscular scoliosis, secondary scoliosis and kyphosis.