On April 4, CMS announced that for cost reporting periods beginning on or after October 1, 2019, providers must comply with a “longstanding” rule to claim reimbursement for crossover bad […]
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Centers for Medicare & Medicaid Services (CMS) issued a memorandum, about changes to the Five-Star Rating system on Nursing Home Compare that will go into effect in April 2019. CMS […]
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Over the past six months, CMS instructed all MACs to complete audits of the FFY 2015 Medicare Cost Report Worksheet S-10s. Each MAC was required to complete 50 audits (approximately […]
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As value-based healthcare becomes the norm, strong clinical documentation improvement (CDI) programs are becoming more important than ever. Value-based healthcare is a healthcare delivery model in which providers are paid […]
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On March 5, CMS announced updates coming in April 2019 to Nursing Home Compare and the Five-Star Quality Rating System. Per CMS, these changes will strengthen the tool for consumers […]
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Attention 340B covered entities participating with Anthem Blue Cross and Blue Shield: Effective April 1, 2019, Anthem requires that a “JG,” “TB,” or another relevant modifier be added to claims […]
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In less than nine short months the RUG-IV payment system will be replaced by the Patient-Driven Payment Model (PDPM). Did you know? RUG-IV payment system ends on September 30, 2019. […]
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On January 31, 2019, the Centers for Medicare and Medicaid Services (CMS) released the revised Federal Fiscal Year (FFY) 2020 Public Use File (PUF). If your hospital requested any changes […]
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Effective January 20, 2019, the process for calculating Indiana Medicaid reimbursement rates for home health services has been repealed. In addition, the requirement to file the Indiana Medicaid home health […]
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Attention 340B covered entities participating with Humana – Managed Care Medicare: Effective January 1, 2019, Humana requires that a “JG,” “TB,” or another relevant modifier be added to claims involving […]
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As we head into the second half of the 2025 calendar year, there are a few major dates that you need to be aware of for wage index purposes. These […]
Physical, occupational, and speech therapy services are vital in skilled nursing facilities (SNFs) for resident recovery, rehabilitation, and quality of life. However, beyond achieving clinical outcomes, therapy departments must navigate […]
By Angela Crawford, Director, and Emilie Knieriem, Senior Manager at Blue & Co. On May 22nd, the House narrowly passed the “One Big Beautiful Bill Act” (H.R. 1). This bill […]
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