RACMonitor: Why Too Much News is a Good Thing

Dr. Ronald HirschOctober 18, 2022

It is time for another multi-topic update. Some weeks produce just too much news to limit my reporting to one topic.

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RACMonitor: AMA Misses Opportunity to Simplify Hospital E&M Coding

Dr. Ronald HirschSeptember 25, 2022

AMA scores a hit with new guidelines; misses simplification of one subset of hospital E&M codes.

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RACMonitor: Medicare Advantage -- No Apparent Advantage for Some

Dr. Ronald HirschSeptember 16, 2022

Complaints are abundant from beneficiaries.

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RACMonitor: Patient Truly Ill? Why Random Audits Could Prevent Recoupment

Dr. Ronald HirschSeptember 9, 2022

Recently, the Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) released an interesting audit. They audited billing of critical care visits by physicians who are employed by Lahey Clinic in Massachusetts. As usual, they planned to audit 100 admissions but then, as they describe, because of the ...

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Hospital Price Transparency in 2022: Lessons Learned, Best Practices

Ogi Kwon, JD, MHAAugust 18, 2022

Federal price transparency requirements for hospitals from the Centers for Medicare & Medicaid Services (CMS) provide patients with an unprecedented amount of insight into the costs for medical services.1  

 

In theory, more pricing information should ...

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RACMonitor: Shameless -- The Paradox of Healthcare Regulations

Dr. Ronald HirschAugust 18, 2022

Lots to report in this regulatory update.

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RACMonitor: CMS Announces New Appeal Rights – Process To Be Determined

Dr. Ronald HirschAugust 12, 2022

Earlier this year, a federal appeals court issued an opinion on Barrows v. Becerra, a long-running class action lawsuit. Filed by a group of Medicare beneficiaries, the suit alleged they had to pay out of pocket for skilled nursing care—despite being hospitalized for over three days—because their stay was outpatient and did not meet the ...

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RACMonitor: Understanding the Medicare Case-By-Case Exception

Dr. Ronald HirschJuly 28, 2022

Exceptions should be never rare nor unusual.

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RACMonitor: Will Rural Emergency Hospitals Save Rural Health Care?

Dr. Ronald HirschJuly 22, 2022

All eyes are on the new proposal put forth by CMS to create Rural Emergency Hospitals.

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RACMonitor: Issues and Implications - MedPAC to Benchmarks to KPIs

Dr. Ronald HirschJuly 10, 2022

Observations, questions and answers during a week of pontification. 

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