News & Insights

We wish all of our readers a Happy New Year. This month we are focusing on two audit topics and a reminder of the Medicare 2018 beneficiary deductibles and coinsurance amounts that are in effect as...

As we approach the end of 2017, we thought it would be helpful to remind providers how the Centers for Medicare & Medicaid Services (CMS) calculates a provider's Additional Documentation...

In early November, the Centers for Medicare & Medicaid Services (CMS) and the Office of Medicare Hearings and Appeals (OMHA) announced two new appeals settlement programs in an attempt to reduce...

Health-related social needs—such as food security, inadequate or unstable housing, lack of utilities or transportation, and domestic violence—all can have a profound impact on an individual's health...

New Acting Secretary of the Department of Health and Human ServicesWith the departure of Tom Price as Secretary of The Department of Health and Human Services (HHS), President Trump has appointed...

Federal funding for the Children's Health Insurance Program (CHIP) is set to expire at the end of September, a change that would likely result in an increase in the rate of uninsured children in the...

Appeals Backlog Update and New Audit StrategyThis month we are writing about two items that may seem to be unconnected but do have a common thread. First, providers and suppliers have once again...

With the continued evolution of health care reform and the battle over its future, the only thing certain about health care right now is uncertainty. Providers are faced with a consistently shifting...

On July 13, the Centers for Medicare & Medicaid Services (CMS) released the Medicare outpatient prospective payment system (OPPS) proposed rule for 2018.Of major importance to hospitals is CMS'...

The rate of uninsured Americans is on the rise, according to a recently released survey from Gallup and Sharecare. In the second quarter of 2017, the uninsured rate measured 11.7%, up slightly from...