Healthcare Reimbursement News

May 14-18: Senate Holds 340B Hearing Amid Surge in Activity

May 10—Congress will once again examine the 340B discount drug program next week amid several judicial and regulatory developments related to the program.

By Rich Daly May 10, 2018

Avoid ED Claim Challenges by Developing CDI Teams

UnitedHealthcare’s new policy of auditing certain emergency department claims should prompt hospitals to seek the expertise of clinical documentation improvement teams in outpatient claim processing. 

By Lola Butcher May 9, 2018

Ask the Experts: Calculating Contract DRGs

What is a simple way to accurately determine my current base DRG rate?

By HFMA May 9, 2018

PHI Disclosure Management in the Business Office: Two Options for Greater Efficiency

Don Hardwick describes ways healthcare organizations can improve the process of releasing medical records to insurers.

By Don Hardwick May 9, 2018

FY2019 Medicare Inpatient Rehabilitation Facility Prospective Payment System Proposed Rule

This summary highlights key provisions of the FY2019 Medicare inpatient rehabilitation facility prospective payment system proposed rule, published by CMS.

By HFMA May 8, 2018

Ask the Experts: Credit Balances

How do other Florida hospitals initiate and work credit balances?

By HFMA May 8, 2018

Medicare Chief Targets Upside-Only ACOs

May 7—Medicare accountable care organizations that don’t accept downside risk are not producing results, says Seema Verma, administrator of the Centers for Medicare & Medicaid Services.

By Rich Daly May 7, 2018

Ensuring a High-Performing Referral Network

To be able to ensure patients receive high-quality care under value-base payment arrangements, primary care physicians require well-developed specialty networks for patient referrals.

By Clive Fields, MD May 7, 2018

FY2019 IPPS/LTCH Proposed Rule

This summary highlights key provisions of the FY2019 IPPS/LTCH proposed rule, published by CMS.

By HFMA May 7, 2018

Own, Partner, or Contract?

There are seven important options hospitals and health systems should consider when contemplating ownership of a post-acute network versus a partnership or contractual arrangement.

By HFMA May 7, 2018
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