Critical Access Hospital (CAH) Method II Claim Updates Effective January 1, 2026, Critical Access Hospital (CAH) Method II claims will be denied if the Attending & Rendering providers have not […]
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On November 21, 2025, CMS finalized updates to Hospital Price Transparency regulations in the CY 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Final Rule. These […]
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Hospital outpatient physical and occupational therapy is one of the few levels of care that has not been forced into a capitated environment. For most hospitals, this service is paid […]
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The Health Resources and Services Administration (HRSA) has approved a 340B Rebate Model Pilot Program that will significantly change how 340B discounts are accessed for covered entities for certain medications. […]
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With the September 2, 2025, deadline for hospitals to submit revision requests to their Worksheet S-3 wage data for the Federal Fiscal Year (FFY) 2027 Wage Index now passed, and […]
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Since October of 2019, the Patient Driven Payment Model, or PDPM, has been the payment system for Medicare Part A in Skilled Nursing Facilities. Prior to this, payment was made […]
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The Importance of Communication with the Team Medicaid is changing the way it pays for care in most states, but that doesn’t preclude us from treating patients and “providing care […]
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Executive Summary The Centers for Medicare & Medicaid Services (CMS) has released the final version of the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual v1.20.1. This […]
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As financial pressures continue to challenge hospitals and with many uncertainties still looming related to the “One Big Beautiful Bill,” hospitals must act now in looking at operational opportunities. The […]
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Effective October 1, 2025 | CMS RAI Manual v1.20.1 The Centers for Medicare & Medicaid Services (CMS) has released the final version of the Minimum Data Set (MDS) 3.0 Resident Assessment […]
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Providing annual wellness visits to patients covered by Medicare is a great way to grow your revenue year after year, whether you’re a practice of one physician or a large hospital […]
Performing Annual Wellness Visits (AWVs) provides a unique value that benefits your healthcare organization, providers and your patients. AWVs align with population health management, and can identify any needs for […]
Beginning in 2011, Medicare began covering the Annual Wellness Visit (AWV) as a yearly appointment with a primary care provider (PCP) to create or update a personalized prevention plan at […]
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