Medicare
publication date
Strategy
He Wanted to Fix Rural America's Broken Nursing Homes. Now, Taxpayers May Be on the Hook for $76 Million.Ronnie Rollins used a controversial loophole to secure $300 million in bonus payments for his nonprofit nursing home chain. A...
Clinical Care
MIPS Study: Health System Clinicians Outperforming Independent CliniciansThe Merit-based Incentive Payment System may give a payment edge to health system-affiliated outpatient clinicians compared to independent clinicians.
Revenue Cycle
Medicare Billing Study Highlights Facilitators and Barriers to CCM UseThe researchers found that CCM use increased among medicine subspecialists from 60,511 services in 2015 to 448,821 in 2018.
Finance
Employers and Private Insurers Paid Hospitals 247% of What Medicare Would HaveRAND 3.0 found that reducing hospital prices to Medicare rates would have resulted in $19.7 billion in savings for employers.
Finance
Fitch says CARES Act Paybacks Won't Be a Problem for Nonprofit HospitalsThe bond rater said the repayments would only be problematic for hospitals "if there is a significant rise in infections...
Strategy
Drug Lobby Rips Trump's 'Most Favored Nation' Mandate on Medicare Drug PricesPhRMA says the White House has "doubled down on a reckless attack on the very companies working around the clock...
Innovation
CMS Launches 'Streamlined Redesign' of Medicare Compare ToolsUpgraded design eases patient access when shopping for healthcare services.
Finance
Medicare to Increase Inpatient Spending by $3.5B in FY '21The final rule also re-emphasizes CMS's push for "pricing strategies based on real world market forces" under the Medicare Fee...
Finance
OIG Plans to Audit COVID-19 DischargesThe OIG will be specifically reviewing claims to determine whether they complied with requirements for the increased MS-DRG weighting.
Revenue Cycle
CMS Will Require Positive COVID-19 Test Results for Increased Inpatient PaymentIf a viral test is performed more than 14 days prior to a patient?s admission, CMS will consider whether there...
Covid-19
CMS Hikes Medicare Inpatient COVID-19 Payments 20%Also Monday, CMS announced that it would resume inspections of provider facilities.
Strategy
Proposed Rule Introduces New CPT Codes for Cardiac Shunting, EKGs, and Lung BiopsiesCoders should also take note of the new HCPCS Level II codes CMS is considering.