Revising The Medicare Hospital Inpatient Prospective Payment Systems (IPPS)

On April 10, the Centers for Medicare & Medicaid Services (CMS) issued the proposed rule (CMS-1808-P) for the Inpatient Prospective Payment System (IPPS) for Fiscal Year 2025. This proposed rule includes updates to payment policies and rates for acute care inpatient hospital services under Medicare.... View More

Revised Regulation from OCR and CMS Ensuring Equal Treatment under Section

The U.S. Department of Health and Human Services (HHS), along with the Office for Civil Rights (OCR) and the Centers for Medicare & Medicaid Services (CMS), made a big decision on April 26, 2024. They created a final rule under Section 1557 of the Affordable Care Act (ACA). This rule is about stoppi... View More

Ensuring Compliance Adapting Your Business to ISOs Revised Climate Change R

Climate change is no longer a concern reserved for environmentalists; it has become a critical issue for businesses across all sectors. The discourse surrounding greenhouse gases, corporate carbon footprints, global warming, and their impact on the planet has been ongoing for decades, involving dive... View More

What are the 4 Principles of Informed Consent

Imagine standing at a crossroads, with multiple paths before you, each leading to a different outcome. Informed consent is your map and compass, guiding you through every medical decision with clarity and confidence. Informed consent is a keystone of ethical medical practice, staying on the principl... View More

Navigating EMTALA: Guidance for Hospitals and Patients

EMTALA, the Emergency Medical Treatment and Labor Act enacted in 1986, stands as a pillar of healthcare accessibility in the United States. It ensures that emergency medical facilities must provide treatment and stabilization to anyone seeking care, irrespective of their ability to pay or insurance ... View More

Embracing G2211 and New Billing Strategies for 2024

Imagine a doctor's visit where the physician spends a lot of time with you, really digging into your health needs. That's what HCPCS add-on code G2211 and New 2024 Billing Opportunities are all about. It reflects the time, effort, and resources doctors put into visits where they build long-t... View More

OMHSAS Provides Telehealth and Medicaid Update - RCPA

In the wake of the COVID-19 pandemic, the landscape of healthcare delivery has undergone a profound transformation. Among the most notable shifts is the widespread adoption of telehealth and Medicaid services. The Office of Mental Health and Substance Abuse Services (OMHSAS), in conjunction with the... View More

What Conditions of Participation are Required by the CMS for Restraint and

Hospitals are required to comply with the Federal requirements set forth in the Medicare Conditions of Participation (CoP) in order to receive Medicare/Medicaid payment. The goal of a hospital survey is to determine if the hospital complies with the CoP set forth in 42 CFR Part 482. Certification of... View More

Navigating CMS 2025 Hospice Proposed Rule: Implications, Changes, and Strat

As the healthcare field keeps changing, hospice providers need to plan carefully to handle new rules and make their operations more efficient. The recent announcement from the U.S. Centers for Medicare & Medicaid Services (CMS) about how they'll pay hospices in 2025 brings both challenges and ch... View More

Understanding NCCI Edits and Compliance

CMS created the NCCI program to help ensure that Medicare Part B claims are coded correctly across the country. CMS is in charge of the NCCI program and makes all the decisions about what it includes. To develop its coding policies, CMS looks at the rules laid out in the American Medical Association... View More

Why Electronic ABN Records Are Better Than Paper-Based ABN

The term ABN might be familiar to you; adhering to vital regulations is critical when serving Medicare patients. Inadequate knowledge may result in costly errors. Insurance payers increasingly shift responsibility to patients, warranting meticulous attention before procedures. It's imperative to... View More

Virtual Specialty Healthcare Next Frontier

In the wake of the COVID-19 pandemic, the dominant branch of virtual health has emerged as a beacon of transformative potential in the healthcare landscape. Despite being considered a disruptor for over a decade, the adoption of virtual health technologies has needed to be faster. However, the curre... View More

Nursing Home versus Home Care: How Medicaid Cuts Shift the Balance