January 8, 2020
News & Insights

The Transparency in Coverage Proposed Rule comment period has been extended from January 14 to January 29, CMS announced. The proposed rule would require insurers to provide personalized price estimates and publish negotiated in-network rates and historical payment information.

December 1, 2019
Briefings on HIPAA

The application of attorney-client privilege is somewhat more complicated in situations where the client is a corporation. Although corporations are entitled to the same protection of confidentiality as noncorporate clients, the application of the privilege often turns on which corporate officials and employees sufficiently personify the corporation as a client.

December 1, 2019
Briefings on HIPAA

In many companies, the compliance officer is the first to become aware of a potential compliance problem that could lead to civil or criminal liability. A best practice is to give the compliance officer the authority to conduct internal investigations.

December 1, 2019
Briefings on HIPAA

Behavioral health facilities and professionals experience some unique challenges when it comes to handling PHI and patient requests. The following article offers tips for handling those challenges and scenarios to consider.

December 1, 2019
Case Management Monthly

Is your hospital doing enough to manage patients with diabetes both in the hospital and when they transition to the next level or care or to home? A recent survey of more than 600 people in 408 U.S. hospitals, finds that some hospitals might be falling short.

December 1, 2019
Briefings on HIPAA

When voluntary disclosure for overpayments is an option rather than an obligation, the provider may encounter diverse opinions among its decision-makers. Some may express a desire to bring the potential problem to the attention of the government and attempt to resolve the matter quickly without incurring criminal penalties, civil fines, or exclusions.

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

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.

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?

November 18, 2019
News & Insights

Expanded price transparency requirements are set to become reality for hospitals effective January 1, 2021. On November 15, CMS released a final rule that pushed ahead with many of the requirements originally included in the 2020 OPPS proposed rule.

Pages