YouCompli

FEBRUARY 22, 2023

This is why Medicare publishes its rules on their Inpatient Prospective Payment System (IPPS) or its Outpatient Prospective Payment System (OPPS). However, there are certain circumstances when Medicare, for example, will reimburse additional amounts beyond the prospective payment rate.

Compliance 52

Compliance US Department of Health and Human Services Overpayments Overpayment 52

Healthcare IT Today

OCTOBER 21, 2024

The following is a guest article by Ashay Thakur, VP of Data Strategy at Cedar Gate Technologies The traditional fee-for-service (FFS) payment model has dominated the healthcare industry’s payment systems for decades. About Ashay Thakur Ashay Thakur is the VP of Data Strategy at Cedar Gate Technologies.

Payment Systems 75

Payment Systems HIPAA Governance Hospitals 75

AIHC

NOVEMBER 15, 2022

The government expects hospitals to be compliant as there has been ample time to prepare for its implementation and to comply with the requirements. In 2019, the federal government finalized a rule requiring hospitals to disclose the prices they negotiate with insurers. How is the Government Monitoring for Noncompliance?

Hospitals 52

Hospitals US Department of Health and Human Services Compliance Governance 52

Compliancy Group

JUNE 28, 2024

This article covers the disincentives that can be imposed on a provider found to have engaged in information blocking. These disincentives withhold money that a provider might have earned under certain federal government incentive or “bonus” programs. The 2024 rule provides a different penalty for provider information blocking.

Medicare 59

Medicare Medicare Hospitals HIPAA 59

Hall Render

NOVEMBER 14, 2024

The governing body is responsible for assuring that this is done as part of their oversight responsibilities set forth in 42 CFR § 484.105(a). Hall Render blog posts and articles are intended for informational purposes only. HHAs are already required by 42 CFR § 484.105 to document, in writing, the services that they furnish.

Payment Systems 40

Payment Systems Medicare Medicare Medicaid 40

Healthcare IT Today

JUNE 29, 2023

The following is a guest article by Isaac Smith, Billing, Coding, and Reimbursement Specialist at Medcare MSO ASCs are types of medical facilities that are subject to stringent regulations. Medicare Payment Resources CMS implemented an Ambulatory Payment Classification-based payment methodology in 2008.

Compliance 52

Compliance Medicare Medicare Medical Billing 52

AIHC

NOVEMBER 29, 2023

We recommend reading Leadership in a Value-Based Care (VBC) Environment in addition to this article. In 1983 Medicare shifted to the inpatient Prospective Payment System (PPS) and DRGs (Diagnostic Related Groups) and only paying a limited number of days to the hospital regardless of the actual length of stay.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

AIHC

NOVEMBER 29, 2023

We recommend reading Leadership in a Value-Based Care (VBC) Environment in addition to this article. In 1983 Medicare shifted to the inpatient Prospective Payment System (PPS) and DRGs (Diagnostic Related Groups) and only paying a limited number of days to the hospital regardless of the actual length of stay.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Hall Render

JULY 14, 2023

On Friday, June 20, 2023, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2024 Home Health Prospective Payment System Rate Update (“PPS Rule”), which has since been published in the Federal Register and is currently open for comment.

Medicare 52

Medicare Medicare Payment Systems COVID-19 52

Physician Credentialing Company

OCTOBER 25, 2024

In this article, we will discuss detailed information regarding what the 90834 CPT code means, who can assign it, and the services covered by it. Medicare and Medicaid may have different payment systems from those of the private health insurance plans.

Licensing 52

Licensing Medical Billing Telemedicine Medicare 52

Hall Render

NOVEMBER 25, 2024

The Nursing Facility ICPG provides that, even if an entity makes an isolated billing error, the entity still has an obligation to repay the overpayment to the government to avoid False Claims Act liability, as explained in the GCPG. Hall Render blog posts and articles are intended for informational purposes only.

Nurses 40

Nurses Compliance Compliance Officers Medicare 40

Drug & Device Law

JULY 31, 2023

The now-venerable Restatement (Second) of Torts §402A (1965), describes “products” as “chattels” or “articles.” The 2005 revisions to Article 2 excludes “information” from the definition of goods and also defines computer software as “information.” Digital files were not “articles,” which must be “material things.” at 1291-92.

Governance 52

Governance Payment Systems Hospitals Licensing 52