As patient care continues to move from inpatient to outpatient settings, hospitals are mobilizing for change. The March 2016 Medicare Payment Advisory Commission Report to the Congress: Medicare ...

After pushback from prominent provider organizations, Aetna is easing a controversial "downcoding" policy for inpatient Medicare Advantage claims. The insurer said in an updated notice late last week ...

Critical Access Hospitals (CAHs) are different - well, at least for Medicare. Prospective payment systems like APCs and MS-DRGs are not used by CAHs. So does this mean that the RACs will not be ...

A few missing words and a lack of understanding have combined to make reimbursement for PD services a difficult problem for dialysis providers. While CMS generally has a good understanding of how PD ...