RAC Focus: Claims Review Targets
RAC Focus: Coding & Documentation of UTI
RAC Focus: Automated Denials
The state of Washington will become the first state to partner with the Centers for Medicare and Medicaid Services (CMS) in the Financial Alignment Demonstration to test a managed-fee-for-service model for providing Medicare-Medicaid enrollees with a more coordinated, person-centered care experience. Through the Demonstration, Washington will use a managed-fee-for-service care model that will build upon […]
Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, doctors, health care professionals and hospitals can qualify for Medicare and Medicaid incentive payments when they adopt and meaningfully use certified electronic health record (EHR) technology. More than 120,000 eligible health care professionals and more than 3,300 hospitals have qualified to participate in […]
CMS has issued a proposed rule that would update Medicare policies and payment rates for End-Stage Renal Disease (ESRD) facilities paid under the ESRD Prospective Payment System (PPS) for calendar year (CY) 2013. The proposed rule would also strengthen incentives for improved quality of care and better outcomes for patients through improvements to the ESRD […]
IPPS Final Rule FY 2012
CMS will now cover transcatheter aortic valve replacement (TAVR) for Medicare patients under certain conditions. Aortic valve replacements are used in patients whose aortic heart valves are damaged, causing the valve to narrow – a condition known as “aortic stenosis.” Once patients experience symptoms of aortic stenosis, treatment is critical to improve their chances of […]
New opportunities that will allow people to more easily receive care and services in their communities rather than being admitted to a hospital or nursing home were announced by HHS, who also finalized the Community First Choice rule, which is a new state plan option under Medicaid, and announced the participants in the Independence At […]