The NAHRI Professional Advocacy Committee is responsible for the research and development of position papers that can help further the revenue integrity profession and bring awareness to matters impacting revenue integrity practices. This position paper from the committee looks at inpatient...
CMS modified its proposal to expand prior authorization and step therapy to protected classes of drugs for Part D and Medicare Advantage beneficiaries, according to a final rule released May 16.
The Revenue Integrity Symposium is the only conference I have seen that is packed with sessions that will give revenue integrity professionals practical information that they can take back and institute the next day to help their facility success financially.
Commercial and government payers track chronic conditions using Hierarchical Condition Category (HCC), and providers can track HCCs to better monitor and project reimbursement and compliance.
U.S. District Judge Rudolph Contreras last week reaffirmed that the U.S. Department of Health and Human Services (HHS) exceeded its authority when it made 2018 payment cuts to outpatient hospitals for certain drugs purchased through the 340B drug pricing program, and extended the ruling to 2019 payment cuts.
