Last week, we brought you a summation of the key provisions in the Medicare Inpatient Prospective Payment System (IPPS) proposed rule for fiscal year (FY) 2025. Today’s article will focus on the quality programs that concern the inpatient setting. Hospitals that do not submit quality data or do not meet all Hospital Inpatient Quality Reporting […]
On April 10, 2024, the Centers for Medicare and Medicaid Services (CMS) issued the fiscal year (FY) 2025 Medicare hospital inpatient prospective payment system (IPPS) proposed rule. While these provisions are not final, they do give current insight into the agency’s thinking in terms of a host of issues concerning the inpatient hospital setting, including […]
We recently brought an alert dealing with allegations against Medicare Advantage (MA) to the effect that MA plans were more prone to deny claims or delay payments when compared to Medicare or third-party payers. Medicare Advantage is back in the news—but, this time, for another reason. Last week, the Centers for Medicare and Medicaid Services […]
In the opening lines of Pink Floyd’s trippy hit, Comfortably Numb, the doctor instructs the patient to provide a response, saying: “just nod if you can hear me.” While not an exact example of what the medical industry means by “informed consent,” it does help us to think about what that term means. What are the […]
We’re supposed to play by the rules but not everybody does. That’s especially disappointing when that person works for the government. Recently, a former state insurance commissioner pleaded guilty to healthcare fraud. How ironic—the very person entrusted with safeguarding the consumer against insurance fraud goes on to engage in a $2.5 million scheme involving false […]
One of things that keeps life interesting is the release of new information. Americans have access to multiple cable news outlets and innumerable headline sources on the web and in print. Sometimes the information is distressing and sometimes it can be heartening. Today’s alert may be seen by many as an example of the latter. […]
In an attempt to address in some meaningful way the serious impact of last month’s cyberattack against Optum’s Change Healthcare—which went on to create ripples in the stability of the nation’s overall healthcare system—the Centers for Medicare and Medicaid Services (CMS) issued this past Saturday an announcement that it was providing immediate help. The agency […]
As many of you know, Change Healthcare was the target of an apparent cyberattack this past Wednesday. The revenue cycle company, which is a subsidiary of UnitedHealth Group’s Optum, indicated that it had managed to “isolate its systems” to mitigate further harm. Optum, UnitedHealthcare, and UnitedHealth Group (UHG) systems were not affected by the attack, […]
We all do it. Unless you’re physically impaired or living off the grid in the wilds of Alaska, most adults will communicate by way of texting at some point in a given year. For many of us, it is a daily occurrence. Interesting how methods for delivering the written word have morphed over the years, […]
