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The Cardiac Bundle – What You Need to Know

Just as many hospitals are adjusting to the Comprehensive Care for Joint Replacement (CJR) bundled payment model, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on the next bundled payment model – the cardiac bundle (bypass surgeries and heart attacks). Many in the industry are not...

Limit Denials through Proactive, Pre-Bill Auditing

The Department of Health and Human Services (“HHS”) issued a proposed rule, published in the Federal Register on July 5th, to change Medicare appeals procedures in an attempt to make the process more streamlined and efficient.  Currently, the HHS Office of Medicare Hearings and Appeals (“OMHA”) has a backlog of...

OIG Issues Spring 2016 Semi-Annual Report

Recently the Health and Human Services (“HHS”) Office of Inspector General (“OIG”) issued its Spring 2016 Semi-Annual Report (“Report”) to Congress for the six-month period ending March 31, 2016. The OIG is mandated to report on a semiannual basis to Congress on the administration of HHS’ programs. The Report summarizes...

What Accountable Care Organizations Need to Know About the MSSP Final Rule

On June 6, 2016, the Centers for Medicare & Medicaid Services (CMS) issued its final rule (accessible at, https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-13651.pdf) strengthening incentives for Accountable Care Organizations (ACO) in the Medicare Shared Savings Program (MSSP). According to the CMS Acting Administrator, the changes “will encourage more physicians to improve patient care by...

HHS’s Cyber Security Efforts Examined by Subcommittee on Health

Recently, a number of hospital computer systems have been hacked and the hackers demanded ransomware. Wichita-based Kansas Heart Hospital is one of the hospitals that decided to pay the “small” ransom after the hackers locked files, a decision that the FBI does not recommend. This latest cyber-attack occurred just one week prior to...

Medicare and Medicaid Program Integrity

On May 24th, the Subcommittee on Oversight and Investigation held a hearing entitled “Medicare and Medicaid Program Integrity: Combatting Improper Payments and Ineligible Providers.” The hearing was held based on recent reports from the Government Accountability Office (“GAO”) and the Department of Health and Human Services (“HHS”) Office of the...

Staying Up-To-Date on MACRA

This past week, the Acting Administrator of the Centers for Medicare & Medicaid Services (CMS) took to social media to provide 4 Key Takeaways on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the comment period: Reminder that providers have the opportunity to invite representatives from CMS...

Announcing Provident’s 2016 Healthcare Compliance Webinar Series

Provident is pleased to announce the 2016 healthcare compliance webinar series. Join Provident as we host complimentary 30-minute, lunch break webinars aimed at keeping you and your organization informed on the latest happenings in the healthcare world. 2016 is the year of compliance! Starting with our kickoff webinar in May, the...

Joint Commission allows texting of orders

The Joint Commission issued a statement Friday on the texting of orders from physicians. Five years ago, the Joint Commission published a FAQ document prohibiting the texting of orders for all practitioners within all healthcare settings.  Friday’s statement, however, changed course for the Joint Commission.  In their response they stated...

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