News

CMS is proposing that hospitals report inpatient payer-specific median negotiated rates with Medicare Advantage organizations and third-party payers on the hospital cost report, according to the fiscal year (FY) 2021 Inpatient Prospective Payment System (IPPS) proposed rule.

The American Medical Association (AMA) recently released a checklist to help medical practices that have experienced a shutdown during the novel coronavirus (COVID-19) public health emergency take steps to safely reopen.

Q: What elements does the Office of Inspector General (OIG) expect to see in a hospital's compliance program and how can we meet them?

Q: HRSA says that COVID-19 diagnoses must be in the primary/principal diagnosis field for hospitals to be reimbursed for treatment of uninsured patients, but this violates the coding guidance we’ve received from CMS and Coding Clinic. How should we handle such claims?

Q: If a patient is incapacitated, the Privacy Rule allows for a doctor to discuss the patient’s condition with a family member, according to HHS. What would the protocol be when the patient is divorced, but the ex-husband or ex-wife makes an inquiry about the patient’s status?

Q: What changes brought about by the 1135 waiver will most affect case managers, and what should they know about these modifications?

CMS updated its novel coronavirus (COVID-19) fee-for-service billing FAQs on April 23 and May 1. The updated FAQs address the appropriate use of disaster-related modifiers, remote physiological monitoring (RPM), and more.

As cyber criminals continue to target healthcare organizations during the novel coronavirus (COVID-19) pandemic, the Office for Civil Rights (OCR) is providing the public with guidance and resources to help combat the threats.

Q: What titles should be considered necessary members of a revenue cycle compliance committee? What structure should it follow?

CMS released a new interim final rule with comment period that grants organizations another round of flexibilities to meet the challenges of the COVID-19 public health emergency, including permitting hospitals to bill for telehealth services and loosening restrictions on COVID-19 testing.