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 analysis of its members’ health status was inconsistent with Medicare fee-for-service requirements.
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News
MA plans don’t have to return overpayments based on members’ health status, judge rules
Source: ACDIS

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 analysis of its members’ health status was inconsistent with Medicare fee-for-service requirements.
Retrospective inpatient study shows gradual increase in upcoding for gastrointestinal surgeries
Source: Revenue Cycle Advisor
Findings from a retrospective study conducted by researchers at Johns Hopkins University School of Medicine in Baltimore show that the number of upcoded cases for patients who underwent gastrointestinal surgeries increased over a ten-year period.
 

Revenue Cycle Advisor Subscriber Content

Revisions to the Common Rule and HIPAA: What you need to know
Source: Revenue Cycle Advisor
After two delays, the revisions to Federal Policy for the Protection for Human Subjects (45 CFR 46), also known as the “Common Rule,” will now go into effect January 21, 2019.
 

Daily Q&A
Q&A: Improving documentation of medical necessity
Source: Revenue Cycle Advisor
Q: How can we help our physicians improve their documentation of medical necessity?
 

Upcoming CMS Events
Monday, 10/15 - Submitting Your Medicare Part A Cost Report Electronically Webcast
Wednesday, 10/17 - Patient Relationship Categories and Codes Webcast
Tuesday, 10/30 - Physician Compare: Preview Period and Public Reporting Webcast
Tuesday, 12/4 - FY 2020 New Technology Town Hall Meeting
 

Product Spotlight

Methods to Improve Price Transparency: Hospital Pricing Strategies for Success

The 2019 IPPS final rule introduced a policy that will require hospitals to post standardized prices on their websites for public consumption. During this 90-minute webinar, regulatory expert Valerie A. Rinkle, MPA, and hospital pricing strategist Brian Workinger will discuss strategies to improve the integrity and defensibility of hospital prices for items and services.
 

    

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Population Health: A Five-Step Plan for Success

This HealthLeaders Media report looks at critical steps Revere Health took to meet population health goals.
 
 

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