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From HFMA: Preparing for a RAC Audit

With the RAC demonstration ended, one of the best ways to prepare for a RAC audit comes in learning from survivors. Elizabeth Lamkin, CEO of Hilton Head Regional Hospital in South Carolina, offered key guidance to HFMA conference attendees in how to ready their organizations for a RAC attack. As you can imagine, the discussion […]

MedPAC Releases June 2009 Report to Congress

On June 15, 2009, the Medicare Payment Advisory Commission (MedPAC) released its June 2009 Report to Congress: Improving Incentives in the Medicare Program (Report). In the Report, MedPAC focuses on how certain incentives could be changed to strengthen the Medicare program and promote quality care for its beneficiaries. In brief, MedPAC addresses: Click title to […]

New CMS Health Information Technology Pages

Health IT Incentives and Support for Adoption. The Recovery Act authorizes bonus payments for eligible professionals and hospitals participating in Medicare or Medicaid if they become meaningful users of certified EHRs. These bonus payments will help lessen the financial burden for many healthcare providers to adopt this technology. Click title to read more…     […]

CMS Moves Permanent RAC Process Forward

Andrea Kraynak, April 15, 2009. CMS continued its efforts this week to educate healthcare providers on the permanent Recovery Audit Contractor program with an Open Door Forum call for Medicare Part B providers on April 14. A similar call for Part A providers was held on April 8. Providers may wish to listen to the […]

Hospital CIOs: EHR Carrot Too Small, Stick Too Big

HealthLeaders Media, April 16, 2009. A new survey of hospital CIOs finds that the federal government’s $36 billion “carrot” of financial reimbursements to install electronic health records won’t be nearly as powerful an incentive as the “stick” of reduced Medicare reimbursements if they don’t. The survey of 100 hospital CIOs was conducted in March and […]

CMS Plans Project to Eliminate Unnecessary Hospital Readmissions

Health Leaders Media – April 13, 2009. CMS today announced the 14 communities around the nation that have been picked for its three-year pilot project to eliminate unnecessary hospital readmissions that cost Medicare billions of dollars annually in preventable care. A study published this month in the New England Journal of Medicine found that nearly […]

Appeals Court: Failure to Respond Is Consent to Medical Necessity

Medical Economics – March 16, 2009. This material originally appeared in the March 6, 2009, issue of Health Lawyers Weekly, a publication of the American Health Lawyers Association (www.healthlawyers.org). On February 27, the Florida District Court of Appeal, First District, found that an insurance carrier forfeits its right under state law to contest the medical […]

CMS Announces 2010 Medicare Advantage & Part D Payment Plans

HHS/CMS — April 6, 2009. CMS ANNOUNCES 2010 PAYMENT INFORMATION FOR PART C MEDICARE ADVANTAGE PLANS AND PART D PRESCRIPTION DRUG PLANS The Centers for Medicare & Medicaid Services (CMS) today issued the Announcement of Calendar Year (CY) 2010 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies.  The Announcement updates and […]

Almost One in Five Medicare Beneficiaries Rehospitalized Within 30 Days – NE Journal of Medicine

Analysis of 2003-2004 Medicare claims data reveals that almost one-fifth (19.6 percent) of Medicare beneficiaries in the FFS program discharged from a hospital were rehospitalized within 30 days, and more than one-third (34 percent) were rehospitalized within 90 days, according to an article in the April 2 issue of the New England Journal of Medicine. […]