A key objective is to enable updates to the MS-DRG payment rates that are no longer dependent on gross charges billed by hospitals that are reduced to cost using hospitals' cost report data. Included ...

Diagnostic-related groups (DRGs) are how Medicare and some other health insurance companies categorize hospital costs to determine how much to pay for a hospital stay. With DRGs, the payment amount ...

The Centers for Medicare & Medicaid Services (CMS) on April 18, 2022, published its annual proposed rule for the federal fiscal year (FY) 2023 Inpatient Prospective Payment System (IPPS) and Long-Term ...

DCS Healthcare, the recovery audit contractor for Region A, posted the following CMS-approved audit issues on February 9-11. 1. MS-DRG validation for joint procedures. MS-DRG validation requires that ...

The Centers for Medicaid & Medicaid Services (CMS) has released the Fiscal Year (FY) 2021 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) ...

The sky is no longer falling. It has fallen, period. Analysis of the newly posted issues from Connolly Healthcare and HDI (Health Data Insights) reveals that for first time Rehabilitation Facilities ...

Connolly Healthcare, the Recovery Audit Contractor (RAC) for Region C posted 77 new issues and DCS, the RAC for Region A posted seven new issues, continuing the pattern that healthcare providers have ...

Hospitals decide how much to bill Medicare for your care based on your diagnostic-related group (DRG). They then charge Medicare based on your DRG tier instead of separately for each of your medical ...