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Thought Leadership

When it comes to thought leadership and staying informed, we’ve got you covered. See below for recent articles, webinars, and downloadable resources available.

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Swing Beds: Medicare Regulatory and Program Design Changes You Need to Know

Swing Beds: Medicare Regulatory and Program Changes You Need to Know

Swing Bed Groundwork must be in place. CAH and PPS swing bed programs need to understand the reason behind the initiation of swing beds and the reliance on understanding skilled […]

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As of October 1, 2019, CMS will Begin Enforcing Accounting Classification Rule for Crossover Bad Debts

CMS to Begin Enforcing Accounting Classification Rule for Crossover Bad Debts

On April 4, CMS announced that for cost reporting periods beginning on or after October 1, 2019, providers must comply with a “longstanding” rule to claim reimbursement for crossover bad […]

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Five Star and Nursing Home Compare Changes Clarified

Five Star and Nursing Home Compare Changes Clarified

Centers for Medicare & Medicaid Services (CMS) issued a memorandum, about changes to the Five-Star Rating system on Nursing Home Compare that will go into effect in April 2019. CMS […]

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Worksheet S-10 Update

Worksheet S-10 Update

Over the past six months, CMS instructed all MACs to complete audits of the FFY 2015 Medicare Cost Report Worksheet S-10s. Each MAC was required to complete 50 audits (approximately […]

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How Clinical Documentation Improvement Can Increase the Bottom Line

How Clinical Documentation Improvement Can Increase the Bottom Line

As value-based healthcare becomes the norm, strong clinical documentation improvement (CDI) programs are becoming more important than ever. Value-based healthcare is a healthcare delivery model in which providers are paid […]

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CMS Improvements to Nursing Home Compare in April 2019

CMS Improvements to Nursing Home Compare in April 2019

On March 5, CMS announced updates coming in April 2019 to Nursing Home Compare and the Five-Star Quality Rating System. Per CMS, these changes will strengthen the tool for consumers […]

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New Requirements by Anthem for 340B Participants

New Requirements by Anthem for 340B Participants

Attention 340B covered entities participating with Anthem Blue Cross and Blue Shield: Effective April 1, 2019, Anthem requires that a “JG,” “TB,” or another relevant modifier be added to claims […]

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Are you ready for the transition to PDPM?

Are you ready for the transition to PDPM?

In less than nine short months the RUG-IV payment system will be replaced by the Patient-Driven Payment Model (PDPM). Did you know? RUG-IV payment system ends on September 30, 2019. […]

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CMS Releases Revised FFY 2020 Public Use File

CMS Releases Revised FFY 2020 Public Use File

On January 31, 2019, the Centers for Medicare and Medicaid Services (CMS) released the revised Federal Fiscal Year (FFY) 2020 Public Use File (PUF). If your hospital requested any changes […]

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Change to the Indiana Medicaid Home Health Cost Report

Change to the Indiana Medicaid Home Health Cost Report

Effective January 20, 2019, the process for calculating Indiana Medicaid reimbursement rates for home health services has been repealed. In addition, the requirement to file the Indiana Medicaid home health […]

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New Requirements by Humana for 340B Participants

New Requirements by Humana for 340B Participants

Attention 340B covered entities participating with Humana – Managed Care Medicare: Effective January 1, 2019, Humana requires that a “JG,” “TB,” or another relevant modifier be added to claims involving […]

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Leveraging 340B Compliance to Improve Profitability

Leveraging 340B Compliance to Improve Profitability

Compliance is often a misunderstood word that most healthcare professionals associate with spending more time and money. Typically, compliance is defined as a certification or confirmation that the doer of […]

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Key Highlights from the TCJA for Healthcare Tax-Exempt Organizations

Key Highlights from the TCJA for Healthcare Tax-Exempt Organizations

The passing of the Tax Cuts and Jobs Act (TCJA) in December 2017 brought about some of the largest changes for exempt organizations since the reformatting of the Form 990 […]

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New Hospital Price Transparency Policy Goes into Effect January 1, 2019

New Hospital Price Transparency Policy Goes into Effect January 1, 2019

In case you are not aware, the Centers for Medicare and Medicaid Services (CMS)’s new hospital price transparency policy goes into effect January 1, 2019. By that date, hospitals must […]

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Eligibility Requirements and Potential Benefits of Becoming a Rural Health Clinic

Eligibility Requirements and Potential Benefits of Becoming a Rural Health Clinic

Is your clinic missing out on potential enhanced Medicare and Medicaid reimbursement? The Rural Health Clinic Service Act of 1977 was established with the intent to increase access to primary […]

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Webinars

2025 Medicare Physician Fee Schedule Final Rule Impacts RHCs

On November 1, the Centers for Medicare and Medicaid Services (CMS) released the CY 2025 Medicare Physician Fee Schedule Final Rule. This final ruling includes several significant changes for Rural […]

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6 Tips to Help Prepare for 2025 Tax Season

The end of 2024 is quickly approaching, and business owners are once again scrambling to put their companies in the best tax position and minimize tax surprises. The question we […]

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Section 1557 Nondiscrimination Rule: November 2nd Deadline

The Department of Health and Human Services (HHS) released the Nondiscrimination in Health Programs and Activities final ruling that speaks on Section 1557 of the Affordable Care Act. This ruling […]

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Internal Audit versus External Audit: The Key Differentiators

Most organizations are familiar with external audits that are performed by licensed auditors to ensure financial statements are accurate. Internal audit refer to systematic and independent examinations of an organization’s […]

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340B Recertification Window Now Open: Reminder for Hospitals

The Health Resources and Services Administration (HRSA) has set the annual recertification window for the 340B Drug Pricing Program for hospitals from August 12, 2024 to September 9, 2024. The […]

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Wage Index Timeline: Mid-Year Update and Looking into 2025

As we head into the second half of the 2024 calendar year and the start of 2025, there are a few major dates that you need to be aware of […]

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