After serving as the president of the National Quality Forum (NQF) for more than six years, Janet Corrigan earlier this month announced her plans to leave her post at the non-profit membership organization,...Read More »
The Department of Health and Human Services (HHS) recovered nearly $4.1 billion in taxpayer dollars in Fiscal Year (FY) 2011 thanks to its increased healthcare fraud prevention and enforcement efforts, according to a recent...Read More »
As of Wednesday, February 29, hospitals can access their Value-Based Purchasing Simulated Hospital Report via QualityNet, according to a CMS spokesman who walked participants through a sample report earlier this week.
Beginning in Fiscal Year (FY) 2013, CMS will reimburse facility under...Read More »
CMS’ Recovery Auditors (previously called Recovery Audit Contractors, now associated with the Recovery Audit Program [RAP]), collected nearly $400 million in overpayments from October 1 through December 31, 2011,...Read More »
Fifty-eight percent of claims billed with MS-DRG 246, percutaneous cardiovascular procedure with drug-eluting stent, with MCC or four-plus vessels/stents, were denied by Trailblazer Health Enterprises, LLC, the Medicare Administrative Contractor for Jurisdiction 4(Texas, New Mexico, Colorado,...Read More »
When hospitals appeal their denials they typically win. The AHA's RACTrac report indicates that hospitals appeal more than 40% of their denials with a roughly 75% success rate.
That’s where CDI professionals come in.Read More »
Malnutrition codes proposed for CC status; 584.8 for downgrade
Inpatient acute care hospitals could see a 2.3% increase in payment rates under the fiscal year (FY) 2013 inpatient prospective payment system (IPPS) proposed rule, released April 24. The 2.3% is a...Read More »
Documentation in today’s records may affect payments in FY 2014, 2015
Fail to reduce costs or fail to meet quality measures and your facility could lose out on those incentive payments—a loss of up to 1% of all MS-DRG payments in FY 2013, and up to 2% by 2017. In July, CMS...Read More »
