The Devil’s in the Details of the New Hospital Price Transparency Rules

Raising sufficient general awareness of the new federal hospital price transparency rules set to take effect in just a little more than three months isn’t so much an issue anymore – industry leaders have been sounding alarm bells for much of the year, and even members of the public at large became well aware of […]

Looming Price Transparency Rule Changes Creating Daunting Challenges for Providers

Federal health officials’ November 2019 announcement of sweeping changes to the rules governing hospital pricing transparency came with an admission that didn’t mince words – Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma called the applicable former rules “clear as mud” to patients, while U.S. Department of Health and Human Services (HHS) Secretary […]

CMS and AMA Fourth Quarter 2020 Coding Updates: Panacea Summary and Recommendations

Our revenue integrity team continually monitors announcements by the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) to bring you the most current and up-to-date coding and billing information. Since our last quarterly update, CMS and AMA have been actively publishing new information that hospitals and providers will need to […]

Three Key Takeaways from the FY 2021 Inpatient Prospective Payment System Proposed Rule

Typically, we would have the Final Rule updates to the Inpatient Prospective Payment System (IPPS) for the 2021 fiscal year (FY) 60 days prior to its effective date. However, this year, citing the COVID-19 public health emergency (PHE), publication was delayed. The final rule was published on September 1, or 30 days before the effective date.

Five Key Takeaways from the CY 2021 Outpatient Prospective Payment System Proposed Rule

On August 4, the Centers for Medicare & Medicaid Services (CMS) released the Changes to Hospital Outpatient Prospective Payment System (OPPS) for the 2021 calendar year (CY). The proposed regulations were published in the Federal Register on August 12, and comments are due by October 5.

Get prepared for the 2021 OPPS Proposed Rule and the IPPS Final Rule with two live complimentary webinars in September.

You’re invited to join us in September on Thurs. September 17th, and Thurs. September 24th, for two complimentary live webinars to get up-to-speed on the OPPS Proposed Rule CY2021 and the IPPS Final Rule for FY2021.  Register today to make sure you  will have the information needed to prepare for the coding and regulatory updates.

Panacea Special Edition / Laboratory Services Update During COVID-19 PHE

Panacea’s consultants have been closely monitoring both Centers for Medicare and Medicaid Services (CMS) and American Medical Association (AMA) published guidance for newly created codes for billing during the COVID-19 public health emergency (PHE). Since February 2020, there have been many new codes added for COVID testing and specimen collection.

UPDATE: Billing for Hospital Outpatient Services During the COVID-19 PHE

On July 28, 2020, CMS released a new FAQ for Hospital Billing for Remote Services (Section LL) and expanded the FAQ for Outpatient Therapy Services (Section MM) in the COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing document[1].

How to Rationalize Chargemaster Prices

Have you ever wondered how hospital prices became so irrational? As is often the case, things changed incrementally. Hospitals and healthcare systems…

Are You Reconciling Your Laboratory Orderables to Your Chargemaster? A How-To in 4 Steps

Over the last several months we’ve seen an uptick in requests from clients nationwide for help reconciling laboratory orderables to chargemasters. In case you’re in this same boat, we wanted to provide some insight into the steps you should be taking.