A federal court on Tuesday found that the U.S. Department of Health and Human Services (HHS) exceeded its statutory authority when it reduced payments for hospital outpatient services delivered outside of hospitals in outpatient provider-based settings. The Centers for Medicare & Medicaid Services (CMS) could appeal the court’s decision on its site-neutral payment rule for hospital outpatient services. Score one for hospitals, but the war is far from over.
Reporting on this developing story during this edition of Monitor Mondays is former CMS official Matthew Albright, chief legislative affairs officer for Zelis Healthcare.
Other segments to be featured on the broadcast include the following:
- RAC Report: Healthcare attorney Knicole Emanuel reports on the latest audits by Recovery Audit Contractors (RACs) and other third-party auditors. Emanuel, a member of the RACmonitor editorial board, is a partner in the Potomac Law Group.
- E&M Coding Changes: Impending evaluation and management (E&M) changes for 2021 and their impact on coding and compliance professionals is reported by Shannon DeConda, founder and president of NAMAS.
- Monday Focus: Ransomware: Healthcare news has been rife with stories of bad actors from overseas planting ransomware in the business systems of hospitals and medical practices large and small. Monitor Mondays national correspondent J. Paul Spencer, a senior healthcare consultant for DoctorsManagement, reports on this ongoing problem and offers advice providers can take to mitigate the risk of global hackers.
- SDoH Report: Ellen Fink-Samnick, a nationally recognized expert on the social determinants of health (SDoH), has the latest news on this trending topic that is attracting significant media attention. Ellen also conducts the Monitor Mondays Listener Survey.
- Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, makes his Monday Rounds with another installment of his popular segment.