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OPPS Drug Acquisition Cost Survey to begin January 1

Wed, 12/10/2025
Revenue Integrity Insider
Revenue Integrity, News, Monitoring and Audits, Compliance

CMS is preparing to launch the Outpatient Prospective Payment System (OPPS) Drug Acquisition Cost Survey to collect acquisition costs for certain outpatient drugs and biologicals.

New edit targets improper payments for hospice services

Wed, 12/03/2025
Revenue Integrity Insider
Revenue Integrity, Billing and Claims, News, Coding and Documentation

CMS recently created a new system edit to help reduce improper Medicare payments for outpatient services provided by acute care hospitals to hospice patients.

2026 OPPS final rule: Hospitals facing expanded site neutrality policies, new price transparency requirements

Tue, 11/25/2025
Revenue Integrity Insider
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS moved ahead with significant expansions to its site neutral payment policies, including reductions to payments for certain services at expected off-campus provider based departments (PBD), additional price transparency requirements, changes to its methodology for setting MS-DRG rates, and more, according to the 2026 Outpatient Prospective Payment System (OPPS) final rule.

Tips for applying to speak at the 2026 Revenue Integrity Symposium

Fri, 11/21/2025
Leadership Council Insider
NAHRI Leadership Council, News, Revenue Integrity

How to assign responsibility for responding to government audits

Fri, 11/21/2025
Leadership Council Insider
Monitoring and Audits, NAHRI Leadership Council, Policies and Procedures, Program Management, Revenue Integrity

Governmental audits are handled differently at every facility, but favorable results are more likely with a strong audit response that meets all AD

Aetna delays implementation of new MA inpatient payment policy

Wed, 11/19/2025
Revenue Integrity Insider
Billing and Claims, Denials and Appeals, News, Payer Contracting, Reimbursement and Payment Methodologies, Revenue Integrity

After receiving negative feedback from industry stakeholders on its new reimbursement approach for certain inpatient Medicare Advantage (MA) claims, Aetna recently extended the policy’s implementation date.

Finding your perspective: Tips for applying to speak at the 2026 Revenue Integrity Symposium

Wed, 11/12/2025
Revenue Integrity Insider
Revenue Integrity

Speaking at the Revenue Integrity Symposium (RIS) is a major professional milestone in the revenue integrity field. Read our tips and suggestions to help you choose a topic and craft a strong application.

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NAHRI Forums

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NAHRI Forum
Wed, 07/12/2017 - 13:31
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