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Update: CMS Guidelines for Outpatient Orthopedic Prosthetics Procedures
- September 16, 2019
- Posted by: dynafios
- Category: Blog, Healthcare Contract Compliance, Hospital Management, Physician Compliance
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Effective January 2018, the Centers for Medicare & Medicaid Services (CMS) revised guidelines concerning coverage for Total Knee Arthroplasty…
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Shared Savings versus CMS Bundled Payments Model: A No-Risk Alternative
- June 13, 2018
- Posted by: Cherie Blehm
- Category: Blog, Healthcare Consulting, Hospital Management, Shared Savings
Hospitals and physician groups wanting to participate in the new CMS Medicare BPCI Advanced demonstration are now on edge as the agency promised to give providers the claims data they need to decide which care bundles to select. It’s now June and provider groups are just getting data with limited time to truly understand the risks associated with the program…
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Physician Alignment Models: Are All Created Equal?
- May 31, 2018
- Posted by: Scott McTaggart
- Category: Blog, Healthcare Consulting, Hospital Management, Physician Alignment, Physician Engagement
We’ve heard this before: Healthcare is a continuously evolving landscape in how care is delivered. This timeless statement is true from the time of the phase-in of DRGs in 1983 through today. Even now we have mandatory and voluntary bundles designed to manage patients well beyond the time of their date of discharge…
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How to Avoid Non-Compliance with Physician Agreements
- May 23, 2018
- Posted by: Cherie Blehm
- Category: Blog, Healthcare Contract Compliance, Hospital Management, Physician Compliance, Time Tracking Software
Recently we learned that a hospital system based in Cincinnati had agreed to pay the federal government $14.25 million to resolve allegations the system violated the False Claims Act, according to the Department of Justice. This could have been avoided…
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How Medical Time Tracking Reduces Compliance Risk
- May 15, 2018
- Posted by: Cherie Blehm
- Category: Blog, Healthcare Consulting, Healthcare Contract Compliance, Hospital Management, Physician Compliance, Time Tracking Software
Even though Stark Law and the Anti-Kickback Statute have been on the books for some time, many healthcare organizations are still tripping over the details of the complex requirements. Healthcare entities discover potential violations of Stark Law during routine compliance audits without even knowing the violation occurred until it’s too late. The penalties for violating Stark Law can be severe—civil monetary penalties or even jail…
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What is a Co-Management Agreement?
- May 10, 2018
- Posted by: Cherie Blehm
- Category: Blog, Healthcare Consulting, Healthcare Contract Compliance, Hospital Management, Physician Alignment, Physician Engagement
“Physician alignment” and “physician engagement” seem to be the buzzwords of the day and these terms are often associated with co-management. Co-management, simply speaking, is a form of hospital-physician integration that does not require hospital employed physicians. However, co-management can be leveraged to further integrate employed physicians…
