Regulatory Insights Archives

Will Medicare Beneficiaries pay more for a procedure no longer on the Inpatient-Only List?

by Dr. J. Morrissey | Apr 13, 2021 | Regulatory Insights

There is still a lot of confusion regarding the impact on Medicare beneficiaries from eliminating the Inpatient-Only List. As recent as last week, an article from The Washington Post titled New cost-cutting Medicare rule may add costs to patients, discussed how this...

Do More Denials Mean More Revenue?

by Dr. Joseph Zebrowitz | Mar 25, 2021 | Regulatory Insights

By Joseph Zebrowitz, MD Denials Are Bad…Maybe Not One of the central tenets of utilization management is that “denials are bad.” Our hospitals have developed a myriad of Key Performance Indicators (KPIs) that reflect this: we track denial rate and total number of...

Hospital Price Transparency: Penalties Potentially Much Higher Than Hospitals Anticipate

by A Sorbelli | Jan 11, 2021 | Regulatory Insights

Within the IPPS policy guidance, CMS has finalized an initiative requiring hospitals report payer-specific negotiated charges. Effective January 1, 2021, any hospital operating in the United States is required to provide clear and accessible pricing information about...

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Will Medicare Beneficiaries pay more for a procedure no longer on the Inpatient-Only List?

Do More Denials Mean More Revenue?

Hospital Price Transparency: Penalties Potentially Much Higher Than Hospitals Anticipate

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