News

Article
CMS
COVID-19
Physician Advisory

Dr. Ronald HirschMay 26, 2020

RACMonitor: Confusion Remains over Medicare Guidance on Treating Patient Homes as Hospital Departments

There is continued confusion over the use of patient homes as off-campus, provider-based clinics for Medicare billing purposes. This is the provision in the Centers for Medicare & Medicaid Services’ (CMS’s) second recent Interim Final Rule (IFR) that allows hospitals to bill for services provided by employed ...

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Article
COVID-19
Physician Advisory

Dr. Ronald HirschApril 19, 2020

RACMonitor: SNF-Eligible Patients with Nowhere to Go

With this pandemic new issues seem to appear daily. The increasing difficulty with skilled nursing facility (SNF) placement led me to write this article and it appears to have struck a chord with many. As with research into medical interventions, the timeline for contemplating, writing, and editing has shrunk ...

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Article
COVID-19
Physician Advisory

Dr. Ronald HirschApril 15, 2020

RACMonitor: The COVID-19 Victims We Aren’t Discussing

The exact number of deaths from COVID-19 is an area of uncertainty. In the midst of a pandemic, data reporting is likely far down on the list of crucial activities. It remains unclear how to count the death of a patient who dies with evidence of infection by coronavirus, but was never diagnosed with COVID-19. ...

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Article
CMS
COVID-19
Physician Advisory

Dr. Ronald HirschApril 9, 2020

RACMonitor: CMS Clarifies Patient Financial Responsibility for COVID-19 Testing

RACmonitor.com news asked Dr. Ronald Hirsch, vice president at R1 RCM, to summarize the latest from the Centers for Medicare & Medicaid Services (CMS) on covering costs for COVID-19 care. In response, Dr. Hirsch provided RACmonitor the following summary.

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Article
CMS
COVID-19
Physician Advisory

Chuck BuckMarch 31, 2020

RACMonitor: CMS Modifies Discharge Planning for Hospitals

As hospitals continue in their struggle to treat patients for COVID-19, the illness caused by the novel coronavirus pandemic, the Centers for Medicare & Medicaid Services (CMS) has modified its requirements for discharge planning.

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Article
CMS
Hospital Management
Medicare
Physician Advisory

Dr. Ronald HirschFebruary 20, 2020

RACMonitor: Price New Technology Right, or Else

There is nothing wrong with adjusting prices to fit your cost-to-charge ratio. New technologies have always posed a financial challenge to hospitals. While they want to provide cutting-edge care to patients, unless a positive margin can be maintained, the costs of those technologies can quickly lead to ...

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Article
CMS
Physician Advisory

Dr. Ronald HirschJanuary 30, 2020

RACMonitor: Navigating the Unknown to Ensure Payment

The debate over percutaneous vertebral augmentation is continuing in 2020, with the release of a new local coverage determination (LCD) from Noridian – a Medicare Administrative ...

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Article
CMS
Hospital Management
Physician Advisory

R1 RCMJuly 19, 2019

Becker's Hospital Review: Why the Outmigration of Cardiology Means Challenges for ASCs, Hospital Volume Loss

CMS' 2019 Outpatient Prospective Payment System rule cleared the way for some cardiac procedures to be performed in ASCs, creating financial uncertainty for hospitals, according to Ronald Hirsch, MD, vice president of regulations and education group for R1 RCM.

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Article
Collections
Healthcare
Physician Advisory

Tracey WalkerJuly 18, 2019

Managed Healthcare Executive: Cadillac Tax Could Affect 1 in 5 Health Plans

The ACA’s tax on high-cost health plans—or “Cadillac Tax”—would affect one in five employers offering health benefits when it takes effect in 2022 unless employers change their health plans, according to a recent analysis.

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Article
Hospital Management
Medicare
Physician Advisory

Dr. Ronald HirschJune 20, 2019

Physician Practice Audit Targets Become Hospital and Health System Compliance Risks

Twenty four percent of the federal budget was spent on Medicare and Medicaid in 2017.

 

The Medicare Trust Fund is forecast to be depleted in 2026. Over 8% of Medicare fee-for-service payments in 2017 were made in error. These factors have all led Congress to put more ...

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