The Hospital Readmission Reduction Program (HRRP) was implemented with the Fiscal Year (FY) 2013 Inpatient Prospective Payment System (IPPS). It is a mandatory Medicare value-based
InIn the FY 2026 Inpatient Prospective Payment System (IPPS) proposed rule, the Centers for Medicare & Medicaid Services (CMS) announced updates to the Transforming Episode
The Centers for Medicare & Medicaid Services (CMS) have issued the display copy of the Final Rule interpreting the 60-day Refund Rule for Medicare Parts A/B (Traditional
Obesity has become a major public health crisis in the United States, with rates rising dramatically over the past several decades. In 1960, fewer than
UnitedHealthcare (UHC) updated their hospital guidelines for observation services. This seemingly small update made Sept. 22, 2024, has led to notable behavioral changes regarding peer-to-peer
Our readers know that Hierarchical Condition Categories (HCCs) are groups of diagnoses. Each diagnosis is classified to a payable or non-payable HCC based on whether
The Centers for Medicare & Medicaid Services (CMS) has announced that payments under the Accelerated and Advance Payment (AAP) Program for the Change Healthcare/Optum Payment
In the old days, you walked into a patient’s room, visually surveyed them, and exclaimed, “(Spicy expletive deleted!) This patient is septic!” and then you
In a landmark move, on April 22, the Centers for Medicare & Medicaid Services (CMS) issued the Minimum Staffing Standards for Long-Term Care (LTC) Facilities
The End-Stage Renal Disease Treatment Choices (ETC) Model, introduced to improve patient outcomes and control healthcare costs, released their second annual evaluation on the impact
The new Healthcare Common Procedural Coding System (HCPCS) codes were released on Nov. 6. These codes include supplies, medications, implants, surgeries, etc. The latest release
I want to explore the fundamental aspects of effective leadership in the healthcare industry, emphasizing the qualities and responsibilities that healthcare leaders must possess to
Bring your questions and join the conversation during this open forum series, live every Wednesday at 10 a.m. EST from June 11–July 30. Hosted by Chuck Buck, these fast-paced 30-minute sessions connect you directly with top healthcare experts tackling today’s most urgent compliance and policy issues.
Fraud convictions don’t just punish a few bad claims; they can wipe out years of reimbursements. Don’t wait for an audit to learn the rules. Join Frank Cohen, MPA, for a live Q&A on spotting red flags, avoiding liability, and protecting your practice. Register now and bring your questions!
Substance abuse is everywhere. It’s a complicated diagnosis with wide-ranging implications well beyond acute care. The face of addiction continues to change so it’s important to remember not just the addict but the spectrum of extended victims and the other social determinants and legal ramifications. Join John K. Hall, MD, JD, MBA, FCLM, FRCPC, for a critical Q&A on navigating substance abuse in 2025. Register today and be a part of the conversation!
Vaccine policies, billing rules, and compliance risks are changing fast! How will your organization adapt? Join John K. Hall, MD, JD, MBA, FCLM, FRCPC, for a critical Q&A on navigating new Medicare mandates, coding updates, and legal challenges in vaccination programs. Get expert answers on billing, compliance, outbreak risks, and operational strategies to protect your facility and patients. . Join us live and bring your questions to the table.
Stop revenue leakage and boost hospital performance by mastering risk adjustment and HCCs. This essential webcast with expert Cheryl Ericson, RN, MS, CCDS, CDIP, will reveal how inaccurate patient acuity documentation leads to lost reimbursements through penalties from poor quality scores. Learn the critical differences between HCCs and traditional CCs/MCCs, adapt your CDI workflows, and ensure accurate payments in Medicare Advantage and value-based care models. Perfect for HIM leaders, coders, and CDI professionals. Don’t miss this chance to protect your hospital’s revenue and reputation!
Struggling with ICD-10-CM coding for diabetes and complications? This expert-led webcast clarifies complex combination codes, documentation gaps, and sequencing rules to reduce denials and ensure compliance. Dr. Angela Comfort will provide actionable strategies to accurately link diabetes to complications, improve provider documentation, and optimize reimbursement—helping coders, CDI specialists, and HIM leaders minimize audit risks and strengthen revenue integrity. Don’t miss this chance to master diabetes coding with real-world case studies, key takeaways, and live Q&A!
Uncover critical guidance. HIM coding expert, Kay Piper, RHIA, CDIP, CCS, provides an interactive review on important information in each of the AHA’s 2025 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.
Uncover critical guidance. Kay Piper provides an interactive review on coding guidelines and more in the AHA’s fourth quarter 2025 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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