CMS recently revised Chapter 4 of the Medicare Claims Processing Manual to provide Method II critical access hospitals (CAH) with updated billing requirements for professional emergency services performed in the...Read More »
CMS recently published a fact sheet detailing improper payments across Medicare and Medicaid programs in fiscal year (FY) 2025, including overpayments, underpayments, and payments that lacked...Read More »
The American Hospital Association (AHA) sent comments to the Medicare Payment Advisory Commission (MedPAC) ahead of their January meeting regarding payment update recommendations. Specifically, the AHA urged MedPAC to:
Recommend higher payment updates for inpatient and outpatient
UnitedHealth Group (UHG) used “aggressive strategies” to increase its Medicare Advantage (MA) risk adjustment scores and collect higher payments from MA enrollees’ diagnoses, according to a new Senate Judiciary...Read More »
CMS recently relaunched the Program for Evaluating Payment Patterns Electronic Report (PEPPER) for short-term acute care hospitals, restoring these...Read More »
