The new CMS “Two-Midnight Rule,” which is intended to provide greater clarity regarding when inpatient hospital admissions are generally appropriate for Medicare Part A payment, goes into effect today. However, in order to address widespread concern among hospitals and doctors…

The new CMS “Two-Midnight Rule,” which is intended to provide greater clarity regarding when inpatient hospital admissions are generally appropriate for Medicare Part A payment, goes into effect today. However, in order to address widespread concern among hospitals and doctors about…

Last month, the Department of Justice (DOJ) announced that it had entered into a $25.5 million settlement with Intermountain Health Care, Inc. (Intermountain), Utah’s largest health system with 22 hospitals and more than 4,500 physicians, to resolve self-reported violations of…

Section 501(r) was added to the Internal Revenue Code by the Patient Protection and Affordable Care Act in order to expand and clarify the federal requirements for tax-exempt hospitals by establishing new standards relating to community health needs assessments; financial…

During the course of an integration negotiation, both hospital executives and physicians focus much of their attention on financial matters, and perhaps rightfully so.  However, a strong governance model may be the key to the long-term success of the relationship. …

The long wait for the HIPAA Final Omnibus Rule is finally over, and it covers a broad range of HIPAA issues, including: The Breach Notification Rule; The HIPAA Enforcement Rule, implementing changes mandated by the HITECH Act; The Privacy and Security Rules,…

Doctors will not see a 26.5% cut in Medicare payments this year. The fiscal cliff deal passed by Congress includes a one-year delay on planned cuts in Medicare payments to physicians. But, the fix is not free. Hospitals will be…

“House members look to ease Medicare audit burden on hospitals” is the title of a recent post by Pete Kasperowicz in his The Hill’s Floor Action Blog.  Last week, four House of Representatives members introduced bill H.R. 6575, that endeavors to ease the burden…

Two major but less discussed programs under the Affordable Care Act took effect October 1, 2012, which are part of the government’s effort to deliver better quality health care.  Both programs aim to reward hospitals for providing more efficient and…

“Same Doctor Visit, Double the Cost” – this is the title of a recent Wall Street Journal article written by Anna Wilde Mathews, which provides a view on the hospital-physician integration phenomenon.  The article describes the higher fees charged by hospitals that…