CMS modified its proposal to expand prior authorization and step therapy to protected classes of drugs for Part D and Medicare Advantage beneficiaries, according to a final rule released May 16.
Researchers at the Regenstrief Institute and Indiana University have developed a new tool for providers to track and potentially identify the early onset of serious underlying issues relevant for multiple chronic conditions that may otherwise go undetected.
CMS finalized a rule on May 7 aimed at streamlining the Medicare appeals process by removing the signature requirement for appeal requests of Parts A and B claims and Part D prescription drug coverage determinations.
According to a recent press release, the Department of Justice unsealed an indictment of two Chinese nationals for a hacking incident that resulted in one of the largest health data breaches of all time.
Q: If our physician only documents “uncontrolled diabetes” in an admitted patient’s chart, but I can see from the lab results in the record that the patient’s blood glucose levels are high, can I go ahead and assign the ICD-10-CM code for diabetes with hyperglycemia?
Q: I’m a registered nurse, and I received treatment at the ER of the hospital where I work. When I asked for a return-to-work note the next day, the physician told me that my supervisor called her the previous evening and asked if I had asked for the note. Is this a HIPAA violation?
HHS failed to meet targeted improper payment reductions for Medicaid and the Children’s Health Insurance Program and has not implemented a required recovery audit plan for Medicare Advantage, according to an Office of Inspector General (OIG) report.
