Centers for Medicare and Medicaid Services (CMS)
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CMS Offers New Settlement for Billing Denials
CMS is offering a new settlement deal for disputed billing denials, offering 66 cents on the dollar in exchange for hospitals dropping their appeals.
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Radiology Practice Settles FCA Claims for $8 million
A radiology group in New York has agreed to pay $8 million to settle claims that it knowingly submitted false claims to Medicare and Medicaid.
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Report Overpayments to CMS Carefully to Avoid More Trouble
CMS expects hospitals and healthcare systems to report overpayments within 60 days of discovery to avoid false claims allegations, but knowing when and how to report is not always easy.
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Tell Staff How Safety Reports Make a Difference
Hospital staff will report safety concerns more when they are informed of how their previous reports helped improve patient safety, according to a recent report from St. Jude Children’s Research Hospital in Memphis.
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Study: ACA Resulted in Fewer Uninsured People in EDs
A new study of patients in Illinois found that fewer uninsured people visited the ED after implementation of the Affordable Care Act.
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Program Targets Frail Seniors, Offering Help with Independence
A case management program that targets frail seniors with a combined case management and technological tool solution produced significant cost savings in a pilot study.
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Lobbying Congress for Case Management in New Era
When case management organizations and advocates descend on Capitol Hill in 2017, they’ll have to assume the groundwork they’ve laid for eight years has been excavated. Years of careful education about case management, established in one-on-one meetings with people who affect healthcare policy, will have been largely erased.
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The ACA is Poised for Chopping Block — What Happens to Case Management?
Case Management Advisor asked healthcare and case management experts to predict how a rescinded or partially repealed ACA might affect the current trend toward population health, care coordination, and enhanced need for case management.
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Improve the Quality of Your Case Management Department through Staffing, Part 1
Correct staffing of acute care case management departments has been a topic of discussion for many years now. One of the greatest challenges has been determining the best ratios of RN case managers and social workers.
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Reduce Readmissions with Better Data Analysis
Readmissions can never be low enough, so hospitals are constantly looking for better ways to reduce them. Some are finding that success depends on collecting good data, because you can’t reduce readmissions if you don’t know what’s bringing people back to your door.