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Proposed Rule FY 2023 for Skilled Nursing Facilities

It is that time of year again! The Center for Medicare and Medicaid Services (CMS) has issued the proposed rule that would update Medicare payment policies and rates for the fiscal year (FY) 2023’s Skilled Nursing Facility (SNF) Prospective Payment System (PPS). The Patient Driven Payment Model (PDPM) was implemented on October 1, 2019. This […]

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Scheduling Solutions for Clinician Work-Life Balance

One of the most challenging conversations in any multi-physician practice or specialty-based hospital employed group is about how to create a fair distribution of on-call and/or inpatient hospital service coverage while balancing the duties of an outpatient practice. The COVID-19 pandemic has contributed to clinician burnout, and physicians and Advanced Practice Providers (APPs) place significant […]

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Tips for Ambulatory and Service Line Optimization

“There may be no faster death of a great idea or business than a dysfunctional team”, said Daniel Newman from Principal Analyst of Futurum Research and the CEO of Broadsuite Media Group. Over the last 15 years, hospitals have acquired or employed clinicians and other ambulatory services. Unfortunately, not all employment arrangements are part of […]

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Why You Need a No-Show and Cancellation Reduction Plan

Many outpatient therapy departments think of a no-show and cancellation reduction plan as a discharge plan. For example, if a patient does not show up a certain number of times, the organization may have a policy to discharge the patient. There is certainly a place for this for patients who repeatedly no-show and cancel. But […]

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340B Hospitals Affected by COVID-19 Update

Great news for 340B Hospitals affected by COVID-19. On March 15, 2022, President Biden signed into law the $1.5 trillion Consolidated Appropriations Acts, 2022. This bill allows Hospitals that have lost eligibility due to a decrease in their Medicare disproportionate share (DSH) percentage as a result of the COVID-19 public health emergency to regain access […]

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New 1099 Reporting Requirements for Payment Apps

Written by Joell Grisel, CPA, Manager, and Thomas Koustenis, Tax Intern Online payment services such as Venmo, PayPal, and many others, are more common than ever, especially for the sale of goods and services. While no banks or hard currency are involved in these transactions, these digital payments for goods and services are still considered […]

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Two Midnight Rule: How to Avoid an OIG Audit

The Two Midnight rule, adopted in October 2013 by the Centers for Medicare and Medicaid Services, states that more highly reimbursed inpatient payment is appropriate if care is expected to last at least two midnights; otherwise, observation stays should be used. Original Two Midnight Rule In general, the original Two Midnight rule stated that, Payable […]

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How to Drive Growth in Elective Surgical Practices

Elective surgical practices have suffered significantly since the beginning of the COVID-19 pandemic. Patients seeking elective surgical treatment had their procedures postponed or canceled as hospital systems were striving to preserve bed capacity in anticipation of or in response to a spike in COVID-19 related admissions. Private practices and hospital systems alike lost incredible amounts […]

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No Surprises Act: How to Ensure Compliance

In 2021, Center for Medicare & Medicaid Services (CMS) issued the No Surprises Act that went into effect on January 1, 2022. This Act provides Federal protections against surprise billing and limits out-of-network cost sharing under many of the circumstances in which surprise bills arise. Prior to this Act, individuals could be “balance billed” for […]

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Coding Changes are Coming, Ensure Your Organization is Ready

For discharges occurring on and after April 1, 2022, coders will have access to new ICD-10-CM and ICD-10-PCS codes. April 1st will also introduce the new Medicare Code Editor (MCE) edit 20 – Unspecified Code Edit. The 2022 IPPS Final Rule stated there would now be coding updates in both October and April. The goal […]

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Indiana Sales Tax Changes for Nonprofits

By: Angela Crawford, CPA, Senior Manager The recently enacted Senate Enrolled Act (SEA) 382 (2022) makes significant changes in the way not-for-profit organizations purchase and sell items exempt from sales tax. Sales tax information Bulletin 10 has been revised to reflect these changes. While sales tax-specific changes are detailed within the bulletin, here are the […]

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Facility Emergency Department Leveling | Stethoscope laying on top of financial reports | Blue & Co., LLC

Is Your Current Facility Emergency Department Leveling Process Working?

Blue & Co. has performed many Emergency Department Leveling Reviews for hospitals. The two most utilized leveling criteria are “points-based” or “intervention-based.” In either case, each hospital must determine which facility resources (or attributes) to include within its criteria, and how these resources crosswalk into ED visit levels (99281-99285). This can create significant reimbursement differences […]

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Cybersecurity in the Construction Industry

Cybersecurity in the Construction Industry

By: Tom Skoog, Cybersecurity & Data Management Practice Leader Cybersecurity for the construction industry is a growing challenge. The industry is moving towards digital connectivity, not only across the supply chain, but also ‘on site’ as more metrics related to performance, progress, and health & safety are monitored in ‘real time’. This increase in connectivity […]

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