Category Archives: Industry Topics

Thank You, Everyone!

By | December 14, 2020

By Dhara Satija, HFMA MA-RI Chapter Board Member & Compliance Committee Co-Chair and Amber Fecik, NEHIA Board Member The HFMA MA-RI Chapter and New England Healthcare Internal Auditors (NEHIA) organization would like to thank all of those who made last week’s virtual Compliance and Internal Audit Conference a success! Thank you to our more than 140 participants who… Read More »

E&M Changes 2021 – What the Changes Mean for Private Practices session by Pam D’Apuzzo, President, RR Health Strategies, LLC

By | December 8, 2020

By: Katherine Record, Executive Director, Beth Israel Lahey Health Medicaid ACOs and Performance Network Compliance & Privacy Strategy, HFMA MA-RI Chapter, Compliance Committee Member, CMS is making changes to E/M codes 99201-99205 and 99211-99215, which are likely to be adopted universally across all payers (including commercial). What do you need to know? For the first time, physical exam… Read More »

Internal Auditing – Operational vs. Clinical Audit session by Scott Brady, Clinical Compliance Auditor and Nick Borges, Compliance Internal Auditor of Lifespan

By | December 8, 2020

By: Garrett Gillespie, Corporate Compliance Officer and Deputy GC, BMC HealthNet Plan; HFMA MA-RI Chapter Compliance Committee Member, What to review to identify risks:  senior management surveys, operational management interviews, regulatory publications (e.g., OIG website), audit staff input, external sources. Audits are won or lost in the preparation.  Think about: What do you need to know? What should… Read More »

Register Now for the Accounting & Regulatory Technical Update

By | September 9, 2020

Get ready to join the MA-RI Chapter of HFMA for the annual Accounting & Regulatory Technical Update.  This year’s program will be a series of four lunchtime virtual sessions (September 16, 23, 30, and October 7) bringing you the great content of this conference in a new format.  Through the four sessions, participants will: Obtain a deeper understanding… Read More »

CARES Act – Provider Relief Fund | Reporting & Single Audit Requirements

Many providers have received several payments from the U.S. Department of Health & Human Services (HHS) and the Health Resources and Services Administration (HRSA) as part of both the general and targeted distributions to reimburse for eligible health care expenses and/or lost revenue attributable to COVID-19. The acceptance and corresponding attestation of these payments were accompanied by numerous… Read More »

The COVID 19 Impact on the Transfer Rule

By | July 27, 2020

As a refresher, under the Post-Acute Transfer Rule (PACT), if a patient was discharged below the Geometric Mean Length of Stay (GMLOS) and the discharge status on the claim indicated a transfer to post-acute care, then the hospital is entitled to a per diem payment amount and not the total amount a full DRG payment would provide. There… Read More »

COVID – 19 | Latest Regulatory Updates and Implications

The US Treasury, Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services (CMS) have implemented financial relief and regulatory flexibility to support health care entities through the unparalleled impact of the COVID-19 pandemic. On May 20, 2020, Kelly Saunders, Chris Anusbigian, and Linsday Wisdom of Deloitte presented a webinar through the MA-RI chapter… Read More »

Sponsored Post: Financial Relief for CARES Act, FEMA and other COVID-19 Programs and Reporting Considerations

* * * * * This post sponsored by Deloitte & Touche, LLP. * * * * * The ongoing COVID-19 crisis has led to the adoption of a number of health care legislative and regulatory programs to provide financial relief for healthcare organizations. As part of receiving these benefits, healthcare organizations are responsible for ensuring that associated… Read More »

Sponsored Post: The Importance of Utilization Management in Healthcare

* * * * * This post sponsored by BESLER. * * * * * In the fast paced, ever-changing healthcare environment hospitals and health systems must be agile to ensure a quality-driven and financially stable operation. Between care complexities, endless reimbursement rules and regulation changes, utilization management in healthcare is paramount. Regulatory Compliance Regulatory agencies such as… Read More »

Closing the COVID-19 Communications Chasm for Providers

By | April 22, 2020

The COVID-19 outbreak is radically transforming healthcare. And it is leaving potential communication vacuums in its path.  Physicians are either overwhelmed with too much incoming information from too many sources or may feel like they are on an island, not knowing where to turn. Here’s where physician associations can play a key role. Physician Performance LLC (PPLLC) is… Read More »