Feeley & Driscoll’s OIG Update: December 2015 The Department of Health and Human Services Office of the Inspector General (HHS-OIG) was established by Congress in 1976 to identify and eliminate fraud, abuse, and waste in HHS programs and to promote efficiency and economy in departmental operations. The OIG is responsible for conducting audits, evaluations, and… Continue Reading
News
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Medicare to Reduce Hospital Payments
http://online.wsj.com/ U.S. News Medicare to Reduce Hospital Payments Cuts Affect Record 2,610 Hospitals Due to Readmissions Within 30 Days By Melinda Beck connect Oct. 3, 2014 7:03 p.m. ET Medicare will cut payments to a record 2,610 hospitals—three-quarters of those eligible—because too many patients were readmitted within 30 days, according to an analysis… Continue Reading
Societies Urge SGR Repeal in Lame-Duck Congress
Robert Lowes http://www.medscape.com/ October 02, 2014 Politics killed a bipartisan bill to repeal Medicare’s notorious sustainable growth rate (SGR) formula for setting physician pay in March, but 3 medical societies are urging its revival in this year’s lame-duck session of Congress, when politics is expected to take a back seat. The bill is the SGR Repeal… Continue Reading
New coding requirements related to Healthcare Common Procedure Coding System (HCPCS) modifier -59 could impact your reimbursement.
DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services News Flash = REVISED products from the MLN “Medicare Learning Network® (MLN) Suite of Products & Resources for Compliance Officers”, Educational Tool, ICN 908525, Downloadable only MLN Matters® Number: MM8863 Related Change Request (CR) #: CR 8863 Related CR Release… Continue Reading
Small Practices Have Fewer Preventable Hospital Admissions
Medscape Medical News, 2014-08-19 Marcia Frellick Despite common assumptions that larger practices offer better care, a new study finds that those with 1 to 2 physicians had 33% fewer preventable hospital admissions than practices with 10 to 19 physicians. Practices with 3 to 9 physicians had 27% fewer admissions. In addition, physician-owned practices had fewer… Continue Reading
HSMN’s Start 10 Program Is Working During This Pause by the Congress
HSMN’s Clients have welcomed the pause, but pause is an opportunity to carefully think through what is really needed to be successful in 2015. Data from the Studies we have done on the aggregate of HSMN’s client base show that the revenue cycle of some hospitals are projected to see an impact of a negative… Continue Reading
Healthcare Legislation Proposed Requires “Cook Book” Medicine
According to CMS, physicians who provide care to Medicare and Medicaid recipients would be granted increased liability protection “if they can demonstrate that they followed Established clinical guidelines based on a bill introduced in Congress recently”. “The Saving Lives, Saving Costs Act” would create a “Safe Harbor” for physicians who “follow best practice guidelines”. This… Continue Reading
Should Hospitals Take Coders Offline for Training in ICD-10-CM/PCS?
Many of HSMN’s clients have decided that they needed to take their coders off line and put them into intensive training for ICD 10-CM/PCS. In order to do that HSMN’s clients needed to know whether they could find a group who could in every way replicate the quality and productivity of the internal staff. HSMN… Continue Reading
Warnings from CMS About Using Smart Phrases in ICD-10-CM/PCS
HSMN advises hospitals and clinical practices on how to overcome the problems of transitioning to ICD-10-CM/PCS after a survey of compliance officers and warnings from CMS indicate concerns about using “Repetitive Terminology” or “Smart Phrases” in their EMRs. The enterprise systems such as Epic offer the possibility for Clinicians to choose phrases that they will… Continue Reading
HSMN tops the list of Revenue Cycle Management Companies in the Most Recent “Modern Health Care Magazine Survey”
For almost 30 years HSMN has worked with Providers of HealthCare in every setting from Academic Medical Centers to Individual Physician Practices. The Firm was founded by Cathy Idema, BSN, MPH in 1987 and has built a practice that encompasses seasoned HealthCare Financial, Operational, Clinical and who represent every function within the Revenue Cycle. HSMN… Continue Reading