Complaints are abundant from beneficiaries.
Lots to report in this regulatory update.
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 ...
Exceptions should be never rare nor unusual.
All eyes are on the new proposal put forth by CMS to create Rural Emergency Hospitals.
Observations, questions and answers during a week of pontification.
Over the past several years, healthcare has begun the move toward the adoption of value-based reimbursement (VBR). The transition is picking up speed as the industry begins to emerge from the COVID pandemic.
Since 2004, the Centers for Medicare and Medicaid Services (CMS) has allowed hospitals to change the status of a patient who was improperly admitted as an inpatient to outpatient by following a process commonly known as
The OIG’s determinations seem to fly in the face of the basic concepts of medical necessity.