The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is key to revenue integrity success. Understanding its benefits and limits is important for any successful revenue integrity program.
Accountable care organizations (ACO) avoid downside risk contracts even though the number of ACO contracts and ACOs with multiple contracts have grown, according to a recent study. The study authors suggest that stronger incentives to take on downside risk are necessary to ensure the success of the ACO model.
A new study suggests a stress-associated neurobiological pathway might link lower socioeconomic status to a higher risk of major adverse cardiac events, a finding which may allow providers to target early intervention treatments to at-risk patients.
CMS released MLN Matters SE19007 on June 28, announcing that it completed round three testing of the activation of systematic validation edits for OPPS providers with multiple service locations. To allow enough time to analyze collected data, the agency is postponing implementation of the edits until October.
Anne Arundel Medical Center in Annapolis, Maryland, will pay $3,154,000 to settle allegations that it submitted false claims to Medicare for medically unnecessary evaluation and management services and separately billing bundled procedures
