Healthcare IT executives are monitoring interoperability decisions. EDITOR’S NOTE:  At press time, the U.S. Department of Health and Human Services (HHS) announced it is extending the public comment period by 30 days for two proposed regulations aimed at promoting the interoperability of health information technology (health IT).  The government is…
Documenting challenges with EHR usage. At the beginning of the month, I attended an interesting conference through Case Western Reserve University School of Medicine called, “Electronic Health Records and Patient Safety: Legal Challenges and Solutions.” I am going to unpack it for you in a two-part series. I have included…
AI-powered solutions must align with applicable coding guidelinesStreamlining the nation’s healthcare system to provide the highest quality of care at a lower cost for patients should be the goal of all healthcare organizations. While prioritizing this initiative, along with reducing waste and improper payments, much attention has been paid to…
New initiative is detailed in the OIG work plan. As many of you are aware, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently released a key addition to its work plan announcing an initiative to investigate and validate their concern of hospitals gaming…
How healthcare providers can best prepare for the worst. Editor’s Note: The following is a transcript of a recent segment on Talk Ten Tuesdays by Julie Dooling, speaking on challenges and tips for healthcare organizations in the face of a natural disaster. Collectively, we continue to learn from experiences where…
CMS released the MPFS on Nov. 1, ending months of turmoil. The Centers for Medicaid & Medicare Services (CMS) released the final rule on the Medicare Physician Fee Schedule (MPFS) and the Quality Payment Program (QPP) on Nov. 1. The 2,378-page document is available in the Federal Register. This marks…
CMS announced on Friday a proposed rule to expand telehealth access for patients. Hospitals, doctors, and other providers seeking an edge in today’s highly competitive healthcare environment would do well to consider a smart telehealth strategy. It’s not an option anymore to think that telemedicine doesn’t fit into your practice.…
CDI can drive down adversarial determinations of medical necessity and costly denials.  In my article published last week, titled Moving in the Right Direction in Getting to the Root Cause of Clinical Documentation Improvement (CDI), I outlined that CDI plays a major role indeed in the context of overall healthcare…
Recent FCA activity focuses on coding compliance issues Recently in healthcare news were articles about two legal actions that cause one to reflect on the need for a strong (or stronger) coding and clinical documentation improvement (CDI) compliance programs.  The first legal action cited the False Claims Act (FCA) and…
The OIG continues to review cases of malnutrition. The diagnosis of severe protein calorie malnutrition is under high scrutiny from the Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG). Today, I’d like to explore the reasons…
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