***** This post is sponsored by Alekman DiTusa. ***** On May 5, 2021, the Massachusetts Appeals Court issued its long-awaited decision in the case of Metropolitan Property & Insurance Company v. Emerson Hospital. Unfortunately, the Appeals Court ruled in favor of Metropolitan and found that Preferred Provider Agreements did not run afoul of G.L. c. 90 §34M, the… Read More »
In late 2014, a Provider Reimbursement Review Board’s (PRRB) decision highlighted numerous issues supporting the need for hospitals to perform retrospective reviews of initial Medicare Disproportionate Share Hospital (DSH) calculations. The case of Barberton Citizens Hospital v CGS Administrators, LLC/Blue Cross and Blue Shield Association (Barberton) led to a series of changes—including both PRRB actions and Centers for… Read More »
If there is one thing that revenue cycle management hates to see, it is a growing upward trend in A/R. A buildup can overwhelm even the most experienced of staff and lead to feelings of exasperation and frustration with no clear solution in sight. When hospitals start to see a trend of their A/R increasing, there are a… Read More »
The HFMA MA-RI Chapter would like to thank all of those who made April 9th Telehealth & Hot Topics in Compliance Virtual Roundtable a success! Thank you to our more than 40 participants who joined us for our first virtual roundtable in 2021. A special thank you to our speakers and moderator, Kyle Faget, Partner, Foley & Lardner,… Read More »
According to the Centers for Medicare & Medicaid Services’ (CMS) 2016 Outpatient Prospective Payment System (OPPS) Final Rule, for hospitals to potentially qualify for Medicare reimbursement related to any given issue, they must first make a cost report claim for the reimbursement. Alternatively, if the provider feels the reimbursement associated with a specific item doesn’t adhere to current… Read More »
When the COVID-19 pandemic hit, healthcare providers suddenly shifted from infrequent (if any) use of telehealth, to near universal adoption of the modality. One year in, what have we learned, and what is here to stay? The public health emergency forced providers and regulators to quickly overcome prior barriers that had long impeded adoption of telehealth. While some… Read More »
HFMA Virtual Roundtable – Speaker Q&A – for Garrett Gillespie, JD, CHIE, Vice President and Deputy General Counsel, Boston Medical Center HealthNet Plan Tell us about your compliance career journey. I think most folks in healthcare have non-linear career paths and I’m no different. I started my career as an employment litigator in San Diego. I assumed that… Read More »
HFMA Virtual Roundtable – Speaker Q&A – for Kyle Faget, Special Counsel Attorney, Foley & Lardner LLP Tell us about your compliance career journey – I jumped into the compliance world headfirst when I joined the government enforcement group at Ropes & Gray as a young associate. I worked on alleged violations of the anti-kickback statute along with… Read More »
HFMA Virtual Roundtable – Speaker Q&A – for Rebecca G. Mishuris, MD, MS, MPH, Chief Medical Information Officer, Boston Medical Center Health System located in Boston, MA Tell us about your career journey – My first introduction to health IT was at the dinner table as a child – my mother an oncologist at Johns Hopkins, my father the… Read More »
HFMA Virtual Roundtable – Speaker Q&A – for Donna Schneider, RN, MBA, CPHQ, CPC-P, CHC, CPCO, CHPC, Vice President, Corporate Compliance & Internal Audit, Lifespan, located in Providence, Rhode Island. Tell us about your compliance career journey – I began my career as a graduate of the University of Connecticut (UCONN) starting my clinical journey as a Registered… Read More »
