On Oct. 9, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to modernize and clarify the regulations that interpret the Medicare physician self-referral law (often called the “Stark Law”). The law prohibits physicians from making referrals for certain healthcare services...
As we get ready to say goodbye to another year of audits and investigations, compliance officers around the country have worked or are working to determine their audit elements for calendar year 2020, in response to the HHS and OIG 2020 Work...
Billions in Estimated Medicare Advantage Payments From Chart Reviews Raise Concerns
We undertook this study because of concerns that Medicare Advantage organizations (MAOs) may use chart reviews to increase risk adjusted payments inappropriately. Unsupported risk adjusted payments are a major driver of improper payments in the...
Machine learning models can be trained to predict chronic diseases such as dementia using electronic medical record (EMR) data, according to a new study published in Artificial Intelligence in Medicine.
In response to the recent occurrences of vaping related disorders and in consultation with the World Health Organization (WHO) Framework Convention on Tobacco Control, the WHO Family of International Classifications (WHOFIC) Network...
Two AI-driven technologies in gastroenterology to watch
Sushovan Guha, MD, PhD, is a gastroenterologist and physician executive director at Banner Digestive Diseases Institute in Phoenix. He shared his thoughts on the uses of artificial intelligence in gastroenterology with Becker's ASC Review.
ICD-10 Coordination and Maintenance Committee Discusses Code Proposals for Sepsis, Synthetic Opioids
At the September meeting of the ICD-10 Coordination and Maintenance (C&M) Committee, members discussed ICD-10-CM proposals for codes for identification of specific synthetic opioids and revisions to the sepsis/severe sepsis codes. Other diagnosis code proposals included cytokine release syndrome...
Data Carries Great Importance for the ICD-11 Transition
As we talk about preparing for the transition from ICD-10 to ICD-11, it is important to realize the importance of data. Healthcare data is important today for population health, determining risk adjustment factors for Hierarchical Condition Categories (HCCs)...
Discharge Planning COP: The Rule is Final, but Compliance is Seen as Impossible
The deadline has come and gone for complying with the Centers for Medicare & Medicaid Services (CMS) Discharge Planning Conditions of Participation Final Rule, and yet hospitals find themselves being asked to do the impossible.
