NAHRI submitted comments to CMS on several key aspects of the calendar year (CY) 2025 Outpatient Prospective Payment System (OPPS) proposed rule.Read More »
CMS improperly paid hospitals over $79 million for mechanical ventilation claims between 2015 and 2021, according to a recent audit report from the Office of Inspector General (OIG).Read More »
Hospitals will need to prepare for a new mandatory bundled payment model and significant changes to coding and billing for certain new technologies, social determinants of health (SDOH), and more, according to the fiscal year (FY) 2025 Inpatient Prospective Payment System (IPPS) final rule.Read More »
Revenue integrity leaders looking to make an impact on the professional fee side of their organizations need to understand the unique opportunities and challenges of a professional fee revenue integrity program, as well as the special coding, billing, and reimbursement rules. To make the case to...Read More »
Organizations could see a flood of new codes along with significant changes to the Medicare Shared Savings Program (MSSP) and coverage of telehealth services, according the 2025 Medicare Physician Fee Schedule (MPFS) proposed rule.Read More »
CMS is considering a significant change to how it pays for certain high-cost radiopharmaceuticals, as well as a sweeping new set of Conditions of Participation (CoPs) aimed at maternal health, and a slew of other changes in the 2025 Outpatient Prospective Payment System (OPPS)...Read More »