Special Bulletin

Federal approval of the Pfizer vaccine, believed to be better than 90 percent effective, could occur before the end of the month. When the long-awaited and much-anticipated COVID-19 vaccine becomes available in the U.S., a development that could take place before the end of the year, a set of new…
EDITOR’S NOTE: Lisa Banker, MD contributed to the following report.Medicare Advantage Organizations (MAOs) were warned by federal health officials last week to issue an appealable organization determination when denying or recouping part or all of a payment from a non-contracted provider. The directive came in the form of a Centers for…
Action applies to the Medicare Accelerated and Advanced Payment Loan Program. In March, the Centers for Medicare & Medicaid Services (CMS) expanded the Accelerated and Advanced Payment Program (AAP) due to the COVID-19 public health emergency (PHE), in an effort to increase cash flow to providers. Under the current terms, repayment for…
Medicare spending on acute-care inpatient hospital services will increase by about $3.5 billion in FY 2021 As the healthcare industry continues to be buffeted by the unrelenting coronavirus pandemic, the Centers for Medicare & Medicaid Services (CMS) has released the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH)…
The move is already stirring up questions and concerns. Amid the more than 300 pages of the Coronavirus Aid, Relief, and Economic Security (CARES) Act signed into law back in March was a clause of great interest to healthcare providers: a provision to increase the weighting factor of the applicable…
The headlines have been coming fast and furious: Judge rules against hospitals in price transparency lawsuit (June 2020) Hospitals to challenge loss on site-neutral payments (July 2020) Hospitals lose legal battle to 304B Drug Cut (July 2020) CMS Proposes eliminating “inpatient only” list (August 2020)   Does anyone see a…
ICD-10-CM Official Guidelines for Coding and Reporting FY 2021 have been updated and released, noting many changes related to COVID19 and its observation and screening codes. EDITOR’S NOTE: During recent weeks, the Centers for Medicare & Medicaid Services (CMS) has been announcing revisions to its regulatory requirements on a near-daily…
NUBC guidance has been updated with the missing ICD-10-AHA code for screening: Z11.59. EDITOR’S NOTE: During recent weeks, the Centers for Medicare & Medicaid Services (CMS) has been announcing revisions to its regulatory requirements on a near-daily basis, in an attempt to ease administrative and logistical burdens on providers amid…