Resource Utilization Group News Today

A new US House task force will look at how to reduce healthcare spending, including ways to modernize healthcare and support access to care. 

A new federal review process designed to lessen improper government payments is sending provider staffs scurrying to justify their coding.

On June 8, 2023, the Centers for Medicare & Medicaid Services (CMS) announced a new nationwide audit of all skilled nursing facilities (SNF) and Hospital swing bed providers that submit...

We’ve all been waiting for this. We knew it was coming! What am I speaking of? The May 4, 2023, notice of Skilled Nursing Facility (SNF) 5-Claim Probe and

The Centers for Medicare and Medicaid Services has issued a proposed rule that would update Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System for fiscal year 2024. It also includes proposals for the SNF Quality Reporting Program (QRP) and the SNF Value-Based Purchasing (VBP) Program for FY 2024 and

The following is a summary of the federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. ...

Jury Orders Eli Lilly To Pay $61 Million - A federal jury in Illinois found that, beginning around 2004, drug manufacturer Eli Lilly deliberately underpaid rebates to...

PDPM led to a “significant reduction” in occupational and physical therapy minutes in its first few months of implementation, a study found.

More than 2,000 providers have weighed in on a proposed 4.6% pay cut, many of them urging CMS to shift its strategy.

All hope is not lost for skilled nursing providers hoping for relief from a planned reduction in PDPM rates, a top payment expert said.