December 5, 2019
News & Insights

The American Hospital Association (AHA) and other hospital groups argue that the final rule is unlawful because it exceeds CMS' statutory authority.

December 4, 2019
News & Insights

Q: We're seeing more patients who are affected by food insecurity. Can you point us toward resources for how to help these patients?

December 4, 2019
News & Insights

Carolinas Hospital in Florence, South Carolina, received $431,757 in Medicare overpayments for incorrectly billed inpatient and outpatient services, according to an Office of Inspector General (OIG) audit report released November 26. Based on the sample, the OIG estimates the hospital may have received at least $3.4 million in overpayments.

December 3, 2019
News & Insights

The U.S. Department of Health and Human Services (HHS) increased civil monetary penalties for HIPAA administrative simplification violations on November 5 in accordance with the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015.  

December 2, 2019
News & Insights

The Centers for Disease Control and Prevention (CDC) updated its clinical guidance for diagnosing and treating electronic cigarette- or vaping-associated lung injuries (EVALI) in light of the approaching 2019-2020 flu season.

November 27, 2019
News & Insights

Medicare made $54.4 million in improper payments to acute care hospitals for post-acute transfers that did not comply with Medicare’s policies, according to a November 1 report from the Office of Inspector General (OIG).

November 27, 2019
News & Insights

Q: I've been hearing the term food insecurity increasingly mentioned as it relates to case management. Is there a standard definition for it?

November 26, 2019
News & Insights

Aegis Medical Group, a physician practice in Mount Dora, Florida, recently notified 9,800 patients that their protected health information (PHI) may have been accessed by a former employee.

December 2, 2019
News & Insights

Q: I'm told, although I'm not convinced, that our payment for Keytruda is denied by Anthem when we use ICD-10-CM code Z51.11 (encounter for antineoplastic chemotherapy) first followed by the code for cancer, i.e., C34.12 (malignant neoplasm of upper lobe, left bronchus or lung). I reviewed the coding guidelines again and that is our instruction. Does anyone have experience with this issue?

November 25, 2019
News & Insights

Q: What is Medicare's criteria for case-by-case approval of an inpatient stay when the patient is not expected to meet the 2-midnight benchmark?

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