As I mentioned in my previous blog, the sign of the times in health care can often be reflected in the proposed (and confirmed) new electronic Clinical Quality Measures (eCQMs). […]

I have to confess I am starting to show my age. When someone mentions sign of the times, I think of Petula Clark Sign of the times, not the Harry […]

In case you missed the release of the Medicare Learning Network (MLN) Matters article SE19012 on June 27, 2019, I wanted to share some insights for all the compliance folks […]

In 2011 the first 32 Medicare ACOs were announced under the CMS Pioneer ACO program. Since then, CMS has made multiple modifications to the program. Initially, most organizations chose to […]

Recently, I came across an OIG announcement “Review of Medicare Part B Claims for Intravitreal Injections of Eylea and Lucentis” released in June 2019. Upon reading this announcement, I pulled […]

The country is revving up for the next election cycle. Like it or not, health care is a focus again and some sword-rattling is taking place regarding the IPPS (Inpatient […]

More than a year after the first draft of the Trusted Exchange Framework and Common Agreement (TEFCA) was published, the Office of the National Coordinator (ONC) for Health Information Technology […]

The March 19, 2019 letter from Seema Verma, CMS Administrator, to Charles Grassley (Chairman of the Committee on finance) assures that CMS is once again analyzing claims data to determine […]

According to a March 7, 2019 article in Modern Healthcare, the Medicare Payment Advisory Commission (MedPAC) has decided to recommend that HHS revisit the national ED coding rules by 2022, citing […]

Compliance requires exacting skills. HIM departments are expected to make sure patient care is appropriately documented, check for medical necessity, assign codes with ICD-10 specificity, identify conditions present on admission […]

On January 24, 2019 CMS released MNL Matters article SE19002, effective January 1, 2018. The change applies to acute care, long-term care and critical access hospitals. As of January 1, […]

The Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) standard is getting widespread support and gathering momentum in adoption. In compliance with this standard, we’ve developed FHIR-compliant Application Programming […]