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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CMS Proposed Rule for Updates to PDPM, QRP, & VBP for FY 2020

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 […]

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Swing Beds: Medicare Regulatory and Program Design Changes You Need to Know

Swing Beds: Medicare Regulatory and Program Changes You Need to Know

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 […]

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As of October 1, 2019, CMS will Begin Enforcing Accounting Classification Rule for Crossover Bad Debts

CMS to Begin Enforcing Accounting Classification Rule for Crossover Bad Debts

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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Five Star and Nursing Home Compare Changes Clarified

Five Star and Nursing Home Compare Changes Clarified

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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Worksheet S-10 Update

Worksheet S-10 Update

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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How Clinical Documentation Improvement Can Increase the Bottom Line

How Clinical Documentation Improvement Can Increase the Bottom Line

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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CMS Improvements to Nursing Home Compare in April 2019

CMS Improvements to Nursing Home Compare in April 2019

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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New Requirements by Anthem for 340B Participants

New Requirements by Anthem for 340B Participants

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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Are you ready for the transition to PDPM?

Are you ready for the transition to PDPM?

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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CMS Releases Revised FFY 2020 Public Use File

CMS Releases Revised FFY 2020 Public Use File

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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Change to the Indiana Medicaid Home Health Cost Report

Change to the Indiana Medicaid Home Health Cost Report

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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New Requirements by Humana for 340B Participants

New Requirements by Humana for 340B Participants

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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Leveraging 340B Compliance to Improve Profitability

Leveraging 340B Compliance to Improve Profitability

Compliance is often a misunderstood word that most healthcare professionals associate with spending more time and money. Typically, compliance is defined as a certification or confirmation that the doer of […]

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Key Highlights from the TCJA for Healthcare Tax-Exempt Organizations

Key Highlights from the TCJA for Healthcare Tax-Exempt Organizations

The passing of the Tax Cuts and Jobs Act (TCJA) in December 2017 brought about some of the largest changes for exempt organizations since the reformatting of the Form 990 […]

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New Hospital Price Transparency Policy Goes into Effect January 1, 2019

New Hospital Price Transparency Policy Goes into Effect January 1, 2019

In case you are not aware, the Centers for Medicare and Medicaid Services (CMS)’s new hospital price transparency policy goes into effect January 1, 2019. By that date, hospitals must […]

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Webinars

Illinois Now Accepting Applications for $28.2 Million in Rural Hospital Transformation Grant Funding

The application window for the Rural Health Transformation Program (RHTP) Hospital Transformation Planning Grants opened on May 19, 2026. Illinois’ 97 eligible rural hospitals have until Wednesday, June 17, 2026, […]

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Preserving 340B Eligibility: Why Hospitals Need a Proactive DSH Strategy

Proactive DSH Strategy for Preserving 340B Eligibility

For hospitals that depend on 340B savings, optimizing the Disproportionate Share Hospital (DSH) percentage that drives 340B eligibility should be treated as a financial and operational priority. In simple terms, […]

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FY 2027 Medicare Wage Index Final PUFs: Key Deadlines and Hospital Correction Rules

FY 2027 Medicare Wage Index Final PUFs: Key Deadlines and Hospital Correction Rules

In early April 2026, a notice was sent from CMS to each MAC regarding the April 30th, 2026, release of the final FY 2027 wage index data PUFs. May 29th, […]

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FY 2027 Hospital Wage Index: MAC Revisions and Appeals – Key Deadlines to Know

FY 2027 Hospital Wage Index: MAC Revisions and Appeals – Key Deadlines to Know

It’s March Madness, and we are not talking about basketball. The clock is ticking on the FY 2027 Medicare Wage Index; this process moves quickly, and missing a deadline can […]

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340B and Indiana Medicaid – Major Changes Planned

340B and Indiana Medicaid – Major Changes Planned

Covered entities have until Friday, March 27th to submit comments to FSSA ahead of proposed changes to eliminate 340B Program savings for Medicaid patients. The window is quickly closing for […]

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CMS Redistribution of Displaced Residents After Hospital Closures

CMS Redistribution of Displaced Residents After Hospital Closures

When a teaching hospital closes, there are several factors the hospital must consider. While there are many financial factors the hospital must figure out, including how to pay outstanding debts […]

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