Case Management Articles by Topic: Regulatory Compliance
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Case Management Weekly, Issue 39, September 26, 2012
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Case Management Weekly, Issue 25, June 20, 2012
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Case Management Weekly, Issue 22, June 1, 2011
Seven U.S. senators believe the Accountable Care Organization (ACO) proposed rule will not only...
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Compliance Monitor, Issue 18, May 4, 2011
Shirlene Reese Boone of Murfreesboro, NC, will serve 12 years in prison followed by three...
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Case Management Weekly, Issue 15, April 13, 2011
Hospitals can begin laying the groundwork for ACOs by developing relationships with postacute...
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Case Management Weekly, Issue 15, April 13, 2011
The ACMA has received a document from CMS that answers questions that ACMA members posed to the...
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Case Management Weekly, Issue 13, March 30, 2011
The ACMA public policy committee presented its concerns about the new face-to-face requirement to...
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Case Management Weekly, Issue 4, January 26, 2011
“Acute Care Hospital Inpatient Prospective Payment System” is now available in print...
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Case Management Weekly, Issue 49, December 8, 2010
Jackie Birmingham has found no evidence that Medicare requires a specific number of discharge...
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Case Management Monthly, Issue 12, December 1, 2010
Inside:
Strengthen postacute relationships to prepare for healthcare reform
Handling IV...
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Case Management Monthly, Issue 12, December 1, 2010
Condition code 44 has been problematic for hospitals since its inception in 2004 due to CMS&rsquo...
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Case Management Weekly, Issue 46, November 17, 2010
The Revenue Cycle Institute asked Kimberly Anderwood Hoy, Esq., about Recovery Audit...
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Case Management Weekly, Issue 43, October 27, 2010
In some situations, only one provider may be capable of meeting a patient’s clinical...
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Case Management Weekly, Issue 43, October 27, 2010
Over the years, case management has evolved as it has continually responded to ongoing changes in...
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Case Management Monthly, Issue 10, October 1, 2010
To begin to think about separating the UR function from the case management role, you must question...
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Case Management Weekly, Issue 39, September 29, 2010
CMS released two additional special edition MLN Matters articles to educate providers regarding...
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Case Management Weekly, Issue 39, September 29, 2010
Physician advisor (PA) involvement in discharge planning varies among organizations. The answer to...
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Case Management Weekly, Issue 34, August 25, 2010
Q. Should physicians write an order for a specific post-acute care provider, such as an HHA or a...
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Case Management Weekly, Issue 28, July 14, 2010
I was privileged to be a part of the American Case Management Association’s (ACMA) Advocacy...
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Case Management Monthly, Issue 7, July 1, 2010
The appeal process is much more complex than conducting a clinical review for an insurance company...
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Case Management Weekly, Issue 26, June 30, 2010
Managing patients in need of mental health services requires the ability to properly navigate the...
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Case Management Monthly, Issue 6, June 1, 2010
Medicare rules require hospitals give patients a choice between postacute facilities. Learn how to...
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Case Management Monthly, Issue 6, June 1, 2010
The American Case Management Association (ACMA) Public Policy Committee is in communication with...
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Case Management Monthly, Issue 5, May 1, 2010
The following are the highlights from the 2010 Case Management Monthly salary survey. We received...
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Case Management Monthly, Issue 4, April 1, 2010
Experts expect the RACs to begin auditing medical necessity this summer. Case managers may be asked...
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Case Management Monthly, Issue 4, April 1, 2010
Considering communication is at the heart of what all case managers do, case management leaders...
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Case Management Weekly, Issue 11, March 17, 2010
The only time a discharge planner should discourage a post-acute referral is when the selected...
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Case Management Weekly, Issue 9, March 3, 2010
The handoff of patients from the hospital to another care provider is a critical transition...
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Case Management Monthly, Issue 3, March 1, 2010
Instead of paying for hospital and physician services separately, the ACE demonstration...
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Case Management Monthly, Issue 3, March 1, 2010
When executing an interstate transfer, case managers must account for different Medicaid programs...
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Case Management Weekly, Issue 8, February 24, 2010
Patient-specific information must be documented in the patient’s medical record to ensure...
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Case Management Weekly, Issue 6, February 10, 2010
CMS recently answered new condition code 44 questions on its FAQ Web site. The CMS answers confirm...
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Case Management Weekly, Issue 6, February 10, 2010
Each month the Revenue Cycle Institute publishes a free sample tool or form for readers. The intent...
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Case Management Monthly, Issue 2, February 1, 2010
Experts answer questions about proper use of condition code 44.
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Case Management Weekly, Issue 4, January 27, 2010
It’s very likely that at one time or another, every person is asked one of the following...
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Case Management Weekly, Issue 3, January 20, 2010
Hospital workers participating in an Institute for Safe Medication Practices (ISMP) survey say the...
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Case Management Weekly, Issue 3, January 20, 2010
What should I do in the following situation? A patient no longer requires hospital level of care...
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Case Management Weekly, Issue 3, January 20, 2010
In a recent HCPro audio conference titled “Condition Code 44 and the Utilization Review...
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Case Management Weekly, Issue 2, January 13, 2010
Essentially ACE changes how Medicare pays for healthcare services. Instead of paying the hospital...
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Case Management Weekly, Issue 49, December 9, 2009
Connolly Healthcare has announced the first issues approved for complex RAC review, and providers...
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Case Management Weekly, Issue 30, November 18, 2009
Change is on the horizon. CMS currently is considering provisions that will promote the efficient...
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Case Management Weekly, Issue 30, November 18, 2009
University Health Care Center (UHCC) in Syracuse, NY modeled its program for handling frequent ED...
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Case Management Weekly, Issue 42, October 21, 2009
Are hospitals required to inform immigration officers when an undocumented alien seeks care?
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Case Management Monthly, Issue 9, September 1, 2009
Do you ever wonder how the postacute transfer rule will affect the reimbursement for a particular...
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Case Management Weekly, Issue 29, July 22, 2009
This week’s tip comes from Deborah Hale, CCS, author of Observation Status: A Guide to...
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Case Management Weekly, Issue 26, July 1, 2009
HCPro, Inc. is pleased to announce the launch of MedicareFind.com, a new regulatory database...
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Case Management Weekly, Issue 21, May 27, 2009
The California Department of Public Health has collected approximately $1.2 million in fines from...
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Case Management Weekly, Issue 18, May 6, 2009
A recent study by the Agency for Healthcare Research and Quality says that hospitals spent over $30...
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Case Management Weekly, Issue 15, April 15, 2009
The Department of Public Health released a report last week that says more than 300 patients in...
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Case Management Weekly, Issue 15, April 15, 2009
This week’s tip, an ask the expert, was submitted by Elaine Hall, LPN, a care...
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Case Management Weekly, Issue 14, April 8, 2009
The article below was written by Jackie Birmingham, RN, BSN, MS, CMA, and is an excerpt from...
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Case Management Weekly, Issue 14, April 8, 2009
A study recently published in The New England Journal of Medicine examined Medicare claims data...
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Case Management Weekly, Issue 10, March 11, 2009
This week’s tip comes from Karen Zander, RN, MS, CMAC, FAAN.
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Case Management Weekly, Issue 7, February 18, 2009
It is no secret that RACs focused on one-day stays in the demonstration project. So what are you...
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Case Management Weekly, Issue 6, February 11, 2009
The Centers for Medicare & Medicaid Services announced on February 6 that the contract protests...
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Case Management Monthly, Issue 2, February 1, 2009
Although many facilities struggle with delivering the Important Message (IM) from Medicare as part...
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Case Management Monthly, Issue 2, February 1, 2009
A patient can come into your facility and get the best care possible, but if you don't have a...
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Case Management Weekly, Issue 4, January 28, 2009
This week’s tip comes from Jackie Birmingham, RN, BSN, MS, CMAC.
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Case Management Weekly, Issue 3, January 21, 2009
A new study concludes that a 19-item surgical safety checklist decreased post-surgical...
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Case Management Weekly, Issue 3, January 21, 2009
CMS announced a temporary delay in the implementation of a competitive bidding program for durable...
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Case Management Monthly, Issue 1, January 1, 2009
ED overcrowding is a problem almost every hospital faces. Many patients inappropriately come to the...
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Case Management Monthly, Issue 1, January 1, 2009
No longer just a Joint Commission requirement, core measures have hit everyone’s radar and...
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Case Management Weekly, Issue 50, December 17, 2008
Too many patients and not enough capacity in the emergency department has been a longstanding...
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Case Management Weekly, Issue 49, December 10, 2008
The United States has difficulty penalizing or closing unsafe hospitals because it lacks a single...
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Case Management Weekly, Issue 48, December 3, 2008
Now seniors and caregivers can find the most suitable and cost effective Medicare Part D plan by...
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Case Management Weekly, Issue 46, November 12, 2008
On October 1, CMS began withholding additional payments to hospitals for certain identified serious...
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Case Management Weekly, Issue 46, November 12, 2008
This week’s tip, an “Ask the Expert,” was provided by Karla Mariska, RN, a...
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Case Management Monthly, Issue 11, November 1, 2008
CMS’ Recovery Audit Contractor (RAC) program elicits feelings of fear, but Brenda Keeling...
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Case Management Monthly, Issue 11, November 1, 2008
If your case management program is like most, it focuses mainly on utilization review and discharge...
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Case Management Monthly, Issue 11, November 1, 2008
The corporate care management staff at the University of Pittsburgh Medical Center (UPMC) knew its...
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Case Management Monthly, Issue 10, October 1, 2008
When New Hanover Regional Medical Center (NHRMC) in Wilmington, NC, wanted to decrease LOS...
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Case Management Monthly, Issue 10, October 1, 2008
Today, hospitals are facing many challenges: Shrinking payer sources, increasing charity care...
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Case Management Monthly, Issue 9, September 1, 2008
$23,772: That's the projected average annual loss per hospital starting October 1, when Medicare...
