Tag Archives: Hospitals

Notes on Day 2 of the JP Morgan Healthcare Conference

San Francisco (Tuesday, January 9, 2018): Day 2 of the 2018 JP Morgan Healthcare Conference provided concrete examples of the trends that have been discussed in recent years – the impact of shifting healthcare delivery modalities on hospitals, the opportunity for retail medicine, the need for more effective management of chronic conditions and the increasing … Continue Reading

Quality, Reimbursement and the Medical Staff

By Karie Rego The most difficult issue a hospital can face involves allegations of poor quality coupled with billing fraud. These allegations can be devastating to a hospital’s operations and its reputation. It is essential that hospital administration, the medical staff, legal and compliance officers work together quickly and efficiently to verify and address allegations.  Hospitals should have … Continue Reading

How to Avoid an Interventional Cardiology Billing and Quality Scandals

By Karie Rego Ever since the Redding Medical Center government investigation found inappropriate percutanteous coronary interventions (PCI), the medically necessity of PCI has been a highly debated topic. This past year, there have been two other similar cases involving providers in Maryland and Pennsylvania. In Maryland, the state even considered adopting it’s own quality guidelines. This is … Continue Reading

ACO Regulations: Still Waiting

By Eric A. Klein Healthcare providers must continue to wait for the Centers for Medicare and Medicaid Services (CMS) to release regulations governing accountable care organizations (ACOs), despite predictions the regulations would be issued last week. The regulations were not forthcoming, possibly due to the tense atmosphere in Washington over the federal budget. ACOs, created by a … Continue Reading

OIG Releases Fiscal Year 2011 Work Plan

By Ken Yood and Lynsey Mitchel The mission of the Office of the Inspector General ("OIG") is to protect the integrity of the programs and operations of the Department of Health & Human Services, for example Medicare, by detecting and preventing waste, fraud and abuse, and identifying opportunities to improve program economy, efficiency and effectiveness. The Work … Continue Reading
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