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Departments Reaffirm "Greatest of Three" Rule and Clarify Outstanding Questions

USA - May 2 2018 Emergency service providers have long opined that payors abuse the Greatest of Three Rule to reduce payments to emergency service providers. On May 1…

TRICARE HPSA Bonus Payments

USA - February 15 2016 Many providers are unaware that they may be entitled to bonus payments of 10% when providing services to TRICARE beneficiaries. The process for…

State Medicaid fraud control units' data mining likely to increase through federal funding

USA - June 11 2013 On May 17, 2013, the Office of Inspector General, U.S. Department of Health and Human Services (OIG), announced a final regulation that would…

Emmy S. Monahan

Increased spotlight on emergency department facility coding by CMS, HHS and DOJ

USA - May 16 2013 Although the professional component of coding for evaluation and management services ("E&M Services") has been scrutinized over the years, until…

Accountable care and clinical integration : what every CEO should consider now

USA - October 25 2010 The Patient Protection and Affordable Care Act (the "Act"), signed into law by President Obama in March, provided for a number of noteworthy healthcare reforms, including provisions establishing a Medicare pilot project for the creation of accountable care organizations ("ACO").

C. Mitchell Goldman