Category: Healthcare News

COVID-19 Diagnosis

Diagnosing COVID-19

Clinical judgment is sufficient for COVID-19 diagnosis. When I was a third-year resident, in 1987, I saw a really sick kid in the ED. He was about 5 years old, had a fever of 104°, and was lethargic in his mother’s arms. His eyes were swollen and infected, and he had a runny nose and […]
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Medicare Payment Rates

CMS Medicare Payment and Policy Changes for FY 2021

The Centers for Medicare and Medicaid (CMS) issued proposed rules updating payment rates and policies for Skilled Nursing Facilities (SNF), Inpatient Psychiatric Facilities (IPF), and Hospices. CMS will accept comments on these rules until June 9, 2020. CMS issued these proposed rules in accordance with its legal obligation to update Medicare payment policies annually rather […]
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SNF and Telehealth Regulation

COVID-19 Impacts Regulations on SNF Waivers and Telehealth

As with last week, RACmonitor asked Dr. Ronald Hirsch, vice president of R1 RCM, to summarize the most pertinent regulatory changes recently arising. The following is a transcript of his reporting today on Monitor Mondays. “First, thank you, everyone, for continuing to care for patients and continuing to take this pandemic seriously,” Dr. Ronald Hirsch […]
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Hospital Price Transparency

Key Opportunities For Hospitals To Boost Margins In The Era Of Price Transparency

About 60 million Americans live in rural areas and depend on local hospitals for care. In 2019, a record 18 rural hospitals closed, bringing the total closures since 2010 to 124, according to the Cecil G. Sheps Center for Health Services Research. With almost 700 more rural hospitals at risk of shutting, the need for strategies to boost […]
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Medicare Advantage Plans

New Directions for Medicare Advantage and the Medicare Drug Plan in 2021

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update Medicare Advantage plan (MA, or Part C) and the Medicare prescription drug benefit (Part D) program. In years past, CMS has also issued a “call letter,” not subject to the regulatory process, to provide additional information for plans to use […]
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2020 MIPS Changes

What You Need to Know About 2020 MIPS Changes

In November 2019, CMS published the 2020 Quality Payment Program Final Rule (the “2020 MIPS Final Rule Changes”). Below is a summary of some of the most notable changes to the Merit-Based Incentive Payment Program (MIPS). For a complete list of changes, please review the 2020 MIPS Final Rule or CMS’ Quality Payment Program Resource […]
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