Since the CMS-HCC risk adjustment payment paradigm took effect in 2003, our company has seen considerable changes, but this year takes the cake, as they say. Frankly, a moment (or really, a week) of silence would be appropriate to mourn the sunsetting of the current MRA program. Seriously. Every year, the Centers for Medicare and Medicaid Services (CMS) publishes a long document detailing...
ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox. Federal lawmakers this week introduced a bill aimed at reducing the more than 20,000 pregnancies that end in stillbirth every year in the U.S. The Maternal and Child Health Stillbirth Prevention Act would explicitly allow federal funding earmarked...
Scientists are revealing new secrets of the reflex that protects our lungs, spreads disease and irritates us all Michael Shiloh had been studying tuberculosis for about two decades when he started wondering about a seemingly basic question: What makes people with TB cough? This is the disease’s hallmark symptom and a main mode of transmission, but despite training as an infectious disease...
Over the years, we’ve written many a blog post on risk adjustment compliance, advising our readers on ways to work successfully with this payment paradigm. And yet, almost every week, the Office of Inspector General (OIG) publishes notices regarding false claims liability for medical practices working with Medicare Advantage plans. Sadly, we’re not surprised. The most recent press release...
Having witnesses or recording devices during procedures requiring anesthesia could help prevent opportunities for sexual assault. Science Photo Library/Getty Images ~~~~~~~~~~ Some patients can have vivid and detailed sexual hallucinations during anesthesia with sedative-hypnotic drugs like propofol, midazolam, diazepam and nitrous oxide. Some make suggestive or sexual comments or act out, such...
ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox. A key congressional committee asked insurance giant Cigna on Tuesday to provide corporate documents so that lawmakers can examine the company’s practice of denying health care claims without ever opening a patient file. The House Committee on Energy...
