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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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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January 20, 2019, the process for calculating Indiana Medicaid reimbursement rates for home health services has been repealed.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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Recommendations for the CMS 2019 RVU Proposal for E&M

Recommendations for the CMS 2019 RVU Proposal for E&M

As you may have heard, the CMS 2019 Relative Value Unit (RVU) weighting for E&M visits is proposed to effectively shift to a two-level system, with level 1 visits receiving […]

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Is now the time to sell? Consider the 4 P's of a successful transition process

Is now the time to sell?

Consider the 4 P’s of a Successful Transition Process There’s a well-known saying, “A rising tide lifts all boats,” suggesting as improvements in the general economy occur so will the […]

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Uncompensated Care S-10 Audits are Coming

Uncompensated Care S-10 Audits are Coming

CMS continues to refine the uncompensated care calculation.  Three factors are utilized to calculate uncompensated care reimbursement for IPPS hospitals.  Factor 3 is developed by compiling the cost of uncompensated […]

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Medicare Annual Wellness Visits Overcoming the Roadblocks to Success

Medicare Annual Wellness Visits: Overcoming the Roadblocks to Success

Medicare developed the Annual Wellness Visit (AWV) benefit to provide coverage in order to ensure that beneficiaries receive the most appropriate care by the most appropriate provider at the most […]

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Hospital 340B Recertification Reminder

2018 Hospital 340B Recertification Reminder

The Health Resources and Services Administration has set the annual recertification of eligibility for 340B drug discounts for hospitals to begin August 15, 2018, and ends September 12, 2018. Mandatory […]

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Low Volume Payment Update

Low-Volume Payment Update

The Centers for Medicare and Medicaid Services (CMS) recently published the Final 2019 Inpatient Prospective Payment System (IPPS) Rule that modified the definition of a low-volume hospital. While the mileage […]

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2019 Hospital OPPS Proposed Rule

2019 Hospital OPPS Proposed Rule

On July 25, the CMS released proposed changes to the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System for 2019. Key proposals include: Increasing […]

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Webinars

Stack of papers next to a statue of a blindfolded woman holding a balance | Medicare Cost Report Appeal Types Infographic | Blue & Co., LLC | Medicare Cost Report Appeals | Medicare Cost Report

Medicare Cost Report Appeal Types & How to Navigate the Appeals Process

To appeal or not to appeal: that is the question. Medicare cost report appeals can be extremely profitable, but which issues are worth the time and effort to appeal? Without […]

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Nurse holding a patient's hand | Post-Acute Care Consulting | Therapy Compliance Monitoring in Alignment with the OIG Program Guide

Therapy Compliance Monitoring Under the OIG Program Guide

The therapy team plays a pivotal role in ensuring quality compliance and promoting person-centered care within nursing facilities. In November 2024, the Office of Inspector General (OIG) released its Nursing […]

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Stethoscope on an RX pad | CMS Issues Guidance Regarding Part B Preventive Vaccines for RHCs and FQHCs

CMS Issues Guidance Regarding Part B Preventive Vaccines for RHCs and FQHCs

In November, CMS finalized a change to how RHCs and FQHCs will bill for certain Part B Preventive vaccines as part of the 2025 Medicare Physician Fee Schedule Final Rules. […]

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What Indiana Nonprofit Hospitals Need to Know: Executive Order 25-22 and House Bill 1004

On January 21, 2025, Indiana Governor Mike Braun signed Executive Order 25-22, addressing the provision of charity care by nonprofit hospitals in the state. The order acknowledges that Indiana does […]

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Needle and medicine vial - 2025 340B Recertification

2025 340B Recertification Reminder for Federal Grantee Organizations

Updated February 11, 2025 A new recertification window has been announced for the 2025 Grantee recertification period for Consolidated Health Centers, Federally Qualified Health Centers & Look-Alikes, Ryan White Clinics, […]

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Bipartisan Support for Increased Internal Revenue Service Oversight of Nonprofit Hospitals

On November 19, 2024, Senators Charles Grassley and Elizabeth Warren submitted this linked letter to the Internal Revenue Service (IRS) urging the agency to increase its oversight of nonprofit hospitals […]

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