Thought Leadership
When it comes to thought leadership and staying informed, we’ve got you covered. See below for recent articles, webinars, and downloadable resources available.
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Outsourcing is a common practice in all areas of business, including the healthcare sector. Although this is a major expense for a hospital, it can have an effect on the […]
Beginning July 1, 2019, Medicare will reject hospital outpatient claims if the service location address on the claim does not exactly match the address on record in the Provider-Enrollment, Chain and Ownership […]
On April 23, 2019, the Centers for Medicare and Medicaid Services (CMS) released the Proposed Rule for the Hospital Inpatient Prospective Payment System (IPPS) for Acute Care Hospitals. The proposed […]
CMS issued proposed rule on April 25, 2019, with updates to the Patient-Driven Payment Model (PDPM), Quality Reporting Program (QRP), and the Value Based Purchasing Program (VBP) for fiscal year […]
Swing Bed Groundwork must be in place. CAH and PPS swing bed programs need to understand the reason behind the initiation of swing beds and the reliance on understanding skilled […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
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. […]
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 […]
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 […]
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 […]
Webinars
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. […]
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 […]
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 […]
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 […]
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 […]
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 […]




























