Revenue Integrity

CMS announced December 18 that it will begin auditing hospitals for compliance with the Hospital Price Transparency final rule in January 2021.

NAHRI’s Revenue Integrity Symposium is a fantastic way to network with and learn from revenue integrity professionals from across the country. But have you considered that RIS can also help hone your professional speaking skills? NAHRI is currently seeking healthcare professionals who are willing to throw their hat into the RIS ring and submit proposals for the 2021 symposium. We will gather October 19–20, 2021, in Kissimmee, Florida. 

The 2021 Outpatient Prospective Payment System (OPPS) final rule, released December 2, moves ahead with most of the provisions of the proposed rule. This should come as a relief to hospitals required to implement most of its policies by January 1, 2021.

The 2021 Medicare Physician Fee Schedule (MPFS) final rule, released December 2, extends certain telehealth benefits but makes cuts to the Medicare conversion factor (CF) to offset evaluation and management (E/M) changes that would otherwise have resulted in significant reimbursement increases. Most provisions of the final rule are effective January 1, 2021.

United Healthcare (UHC) recently announced that it is delaying the implementation date of its unique laboratory code policy. The policy, which was originally set to go into effect January 1, 2021, will be delayed until January 1, 2022.