Tag Archives: bill malm

“Finally Friday!” Will CMS or Congress Kill Medicare’s 3-Day Qualifying Stay for SNF Coverage?

3-Day Stay for SNF Coverage: Will It Stand or Not? Regs Review & Another Quiz from Dr. Pahuja Plus: Interview with a Physician Advisor Double Certified as a Medical Auditor In a previous week, we heard from two practicing Physician … Continue reading

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“Finally Friday!” CY2015 OPPS Proposed Rule Report & Confusion on Status Decisions

Two Special Reports, Two Special Guests: Expert Physician Advisor, Dr. Deepak Pahuja Returned to Our Show: Common Misconceptions in Admission Decisions Hear Dr. Pahuja’s Latest Recommendations to Dispel Them Get the Handouts & Watch the Replay Here Dr. Deepak Pahuja, … Continue reading

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“Finally Friday!” CMS OMHA Settlement Conferences and Statistical Sampling

OMHA Settlement Conferences and OMHA Statistical Sampling Alternate but Rejected Title for this Show: How CMS Plans to Use Your Money to Solve Their Problems We were joined this week by Jessica Gustafson and Abby Pendleton from The Health Law … Continue reading

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“Finally Friday!” Decision Trees for 2-Midnight Rule Conversions

Joining us this week was a panel of experts discussing our handouts, decision trees for: Day One Day Two Day Three & Beyond Conversion of OP to IP Find the PDFs below – download and post, copy, distribute, whatever – … Continue reading

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“Finally Friday!” MAC Probes, AHA Lawsuits, and OIG Reports on E/M

Bill Malm of Craneware reviews some new OIG Reports, foreshadowing perhaps a flood of E/M Audits by CMS contractors. We also hear from Dr. Ron Hirsch of Accretive PAS about some of the insanity coming out of the MACs in Probe and Educate. Jessica Gustafson and Abby Pendleton from The Health Law Partners give us some legal perspective on the OIG postings, and a short review of the recent AHA filing of a mandamus complaint – a filing seeking a judicial remedy to require CMS to “meet statutory deadlines for administrative review of denials” for Medicare claims. Continue reading

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“Finally Friday!” 2014 OPPS Proposed Rule – Packaging Horrors

This session was recorded on Friday, August 30, 2013. Today’s show, our friend Bill Malm, ND, RN, CMAS from Craneware joined us, and went over what he’s found in his study of the OPPS Proposed Rule for FY2014, aka CMS-1601-P. The … Continue reading

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