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Monitor Mondays

Sepsis-3: Not in New York

January 21, 2019 Chuck Buck | Ronald Hirsch, MD | Nancy Beckley | Knicole Emanuel, Esq. | Mary Inman, Esq. | Dennis Jones | Denise Wilson
Monitor Mondays
Sepsis-3: Not in New York
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Monitor Mondays
Sepsis-3: Not in New York
Jan 21, 2019
Chuck Buck | Ronald Hirsch, MD | Nancy Beckley | Knicole Emanuel, Esq. | Mary Inman, Esq. | Dennis Jones | Denise Wilson

On Tuesday, the Healthcare Association of New York (HANY) informed its reported 210 member hospitals that the Empire State would not use the UnitedHealthcare (UHC) Sepsis-3 criteria when reviewing claims to validate sepsis for payment. New York state law defines sepsis with systemic inflammatory response syndrome (SIRS) criteria, otherwise known as Sepsis-2.

Dennis Jones, the administrator of patient financial services for Montefiore Nyack hospital, was there Tuesday when HANY made the announcement during its regularly scheduled managed care advisory group meeting. Jones, who was among the earliest correspondents to join Monitor Mondays in 2010, will return to the broadcast this coming Monday and report on this newly developing story. Also reporting on Sepsis-3 will be Denise Wilson, vice president of Intersect Healthcare + AppealMasters.

The broadcast rundown also will include:

  • False Claims Act: Nationally recognized whistleblower attorney Mary Inman, partner in the London office of Constantine Cannon, will report on Intermountain taking its challenge of False Claims Act (FCA) to the Supreme Court.

  • The Audit Report: Healthcare attorney Knicole Emanuel, partner in the Potomac Law Group, will report on the latest activities by auditors, including the Recovery Audit Contractors (RACs).

  • Hot Topics: Monitor Mondays senior correspondent Nancy Beckley, president and CEO of Nancy Beckley and Associates, will return to report on all the latest hot topics.

  • Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services, will be making his Monday Rounds with another installment of his popular segment.
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Show Notes

On Tuesday, the Healthcare Association of New York (HANY) informed its reported 210 member hospitals that the Empire State would not use the UnitedHealthcare (UHC) Sepsis-3 criteria when reviewing claims to validate sepsis for payment. New York state law defines sepsis with systemic inflammatory response syndrome (SIRS) criteria, otherwise known as Sepsis-2.

Dennis Jones, the administrator of patient financial services for Montefiore Nyack hospital, was there Tuesday when HANY made the announcement during its regularly scheduled managed care advisory group meeting. Jones, who was among the earliest correspondents to join Monitor Mondays in 2010, will return to the broadcast this coming Monday and report on this newly developing story. Also reporting on Sepsis-3 will be Denise Wilson, vice president of Intersect Healthcare + AppealMasters.

The broadcast rundown also will include:

  • False Claims Act: Nationally recognized whistleblower attorney Mary Inman, partner in the London office of Constantine Cannon, will report on Intermountain taking its challenge of False Claims Act (FCA) to the Supreme Court.

  • The Audit Report: Healthcare attorney Knicole Emanuel, partner in the Potomac Law Group, will report on the latest activities by auditors, including the Recovery Audit Contractors (RACs).

  • Hot Topics: Monitor Mondays senior correspondent Nancy Beckley, president and CEO of Nancy Beckley and Associates, will return to report on all the latest hot topics.

  • Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services, will be making his Monday Rounds with another installment of his popular segment.