I’m on Medicare. What changes are coming in 2027, and how can I make sure I’m not paying too much for my coverage? If you have Medicare, now’s a good time to make sure you’re getting the best coverage for your…
By Phil Galewitz, KFF Health News Millions of Medicare enrollees who buy stand-alone prescription drug plans will see their average monthly premiums rise by 50% in 2027, a new analysis finds. But enrollees can avoid the average increase — from $34 a month to…
By Stephanie Armour and Amanda Seitz | KFF Health News Democrats’ decisive sweep of the U.S. House and Senate in Tuesday’s elections will reshape the direction of federal health policy — setting the stage for oversight investigations, a legislative push to reverse…
Last week I once again presented to the National Uniform Billing Committee (NUBC), asking for such a code to be established. During that meeting, one of the members came up with an even better idea: establishing two condition codes, one…
Not every readmission counts against your hospital, but knowing which ones do can make a significant financial difference. Join Dr. Ronald Hirsch to understand Medicare and commercial payer readmission rules, reduce unnecessary penalties, and focus resources where they have the…
Hospitals closely monitor observation utilization, observation length of stay, avoidable days, and discharge delays. What is less visible is the uncompensated care delivered to patients who do not need (or no longer need) outpatient hospital-level treatment, but cannot leave because…
Last week I received a message from a hospital asking about a letter they received from their Medicare Administrative Contractor (MAC). This letter, addressed to their generic “corporate compliance officer,” indicated that the MAC had identified possible aberrancies in their…
False Claims Act violations can lead to costly settlements, investigations, and Medicare exclusion. Learn current DOJ enforcement priorities, common healthcare fraud risks, and practical strategies to strengthen compliance and reduce exposure. After attending this webcast, you'll be better prepared to:…
Democrats’ decisive sweep of the U.S. House and Senate in Tuesday’s elections will reshape the direction of federal health policy — setting the stage for oversight investigations, a legislative push to reverse cuts to the Affordable Care Act and Medicaid, and…
I’ve talked a lot about insurance fraud over the years. Americans pay $308.6 billion annually just to cover the cost of insurance fraud, according to a 2022 study conducted by Colorado State University for the Coalition Against Insurance Fraud. That’s an average…
Eligibility, parts A‑D, Advantage, dual eligibility, and state program changes.
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