Q: A payer has begun denying authorization for admissions and diverting patients from our hospital to one of our competitors, even when our hospital is closer. Is this a common practice among payers? What language should we add to the contract to discourage it?
Several national groups representing accountable care organizations and physicians expressed concern that CMS has delayed disbursement of the 5% advanced alternative payment model (APM) bonus.
This week’s Medicare updates include an OIG review of emergency ambulance transports from hospitals to skilled nursing facilities, revisions to the State Operations Manual regarding critical access hospitals adding provider-based locations, coding revisions for national coverage determinations, and more!
This week’s Medicare updates include an article for health care professionals to use as a resource throughout the 2019-20 flu season, an OIG data brief on using CERT data to identify high-risk home health agencies, revisions to the Claims Processing Manual regarding billing for Part B inpatient services, and more!
