According to a recent report from the RAND Corporation, public rankings of hospital quality would be more accurate and useful if they incorporated the different ways patients judge a hospital’s performance.Read More »
In a ruling, a U.S. district judge sided with UnitedHealth, which argued that the rule requiring MA plans to return overpayments based on an analysist of its members...Read More »
Along with quality measure removals in the 2018 OPPS and MPFS final rules, CMS continues to propose additional removals in its proposals for 2019 and it wants greater flexibility to remove quality measures in the future.Read More »
Last week, CMS released a report on the first-year performance of the agency’s Next Generation ACO model. For the 2016 performance year, the model generated net savings for Medicare of about $62 million while...Read More »
Q:We are receiving denials on the grounds that encephalopathy must be resolved prior to discharge in order to be present. How would you suggest we fight these denials?Read More »
Roughly 150 physician groups sent a letter to CMS Administrator Seema Verma on Monday both praising and criticizing the administration’s planned changes in the 2019 physician fee schedule.Read More »
by Denise Wilson, RN, MS, RRT, and Karla Hiravi, RN, BSN
Acute kidney injury (AKI) is a sudden and temporary loss of kidney function, while acute tubular necrosis (ATN) is kidney injury characterized by acute tubular cell injury and dysfunction. CDI professionals need to...Read More »
The end of last week brought news of a lawsuit that appears to have broad and deep ramifications for the CDI profession. Providence Health & Services, a 34-hospital system headquartered in Renton, Washington, has been hit with a $188.1 million lawsuit for...Read More »
