CMS and the OIG will conduct a two-part study to assess inpatient hospital billing due to unspecified upcoding in hospital billing—either accidentally or intentionally reporting higher severity codes than supported by documentation to increase payment.Read More »
The federal government has intervened in a lawsuit against Sutter Health, taking the side of a whistleblower who claims the nonprofit health system inflated the risk scores of Medicare Advantage plan enrollees to secure higher risk-adjusted payments.Read More »
Earlier this year, ACDIS formed the Regulatory Committee with the stated purpose of reviewing regulatory policy, coding, and clinical updates, commenting to agencies on behalf of ACDIS and providing summary, interpretation...Read More »
The AHA, the Association of American Medical Colleges, Mercy Health Muskegon, Olympic Medical Center, and York Hospital sued the Trump administration last week over...Read More »
In FY 2018, 57% of hospitals earned Medicare incentive payments under the Hospital Value-based Purchasing Program. In FY 2019, that number will decline to 55%, or roughly 1,550 hospitals.Read More »
