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Policy & Law

ICD-10: The Countdown is Over – Last Minute Tips

October 1, 2015 by Moira O'Connell

October 1st is here and with it arrives ICD-10. Whether the looming implementation date of the new codes sent your organization into a state of urgency or the date felt like a non-event, ICD-10 is here. There will be a strong focus on the transition to ICD-10 in the coming months and we know it isn’t going to be easy, as resources and employees get allocated to fix errors and educate staff.[read more]

Why drug price regulation should not be ruled out

October 1, 2015 by David E Williams

I’m a proponent of free markets and in general defend drug companies in their price setting, especially when they’re introducing new, innovative products with real clinical and financial benefits. See, for example, Hooray for high-priced hepatitis treatment Sovaldi.But we have to remember that the reason high prices can...[read more]


Bacteriophages: A Ray of Hope in the Fight against Antibacterial Resistance?

September 29, 2015 by Varsha Jain

Resistance to antibiotics is currently one of the world’s most pressing issues related to public health. Almost all classes of common and potentially deadly bacteria have become strong and less responsive to antibiotic treatments over the years. In India, some cases of infections resistant even to last-resort antibiotics such as colistin...[read more]


How Much Liposuction is Safe? The Answer Differs for Everyone

September 29, 2015 by Jenna Cyprus

Liposuction is always a hot topic, particularly when it comes to ethics. Another hot topic revolves around how much is acceptable for each patient. Many patients who see a professional about liposuction want more out of the surgery than the doctor agrees to give. In fact, it’s dangerous to give a patient more liposuction than the amount that’s been designated by the American Society of Plastic Surgeons (ASPS).[read more]

Top at Risk DRG’s in the Post ICD-10 Era & How to Proactively Address Coding Challenges

September 28, 2015 by Phil C. Solomon

 ICD-10 is expected to be fraught with significant challenges to coding quality because:Dealing with a very new coding and documentation paradigmThe predictability in coding due to an unpredictable financial environmentLimited experience in DRG analysis and claims processing best practicesThe key to working in the new ICD-10 system...[read more]

12 Common IRO Questions Answered

September 28, 2015 by Moira O'Connell

Independent Review Organizations (IROs) exist to “ensure thatevidence-based and objective physician review services are provided along the continuum of care. IROs act as a third part and help alleviate the pressure of reviewing claims and make decisions without influence from either end of the situation.” We’ve been talking a lot about the major benefits that external IROs can provide, from helping support effective decision making to giving objective, unbiased reviews. We thought we would take this week to give some IRO basics, for those who want help understanding exactly what IROs are and what they does.[read more]

Contract Renewal May Result in Loss of Business for Florida Hospital

September 28, 2015 by Katie Brant

Adventist Health System, parent company to Florida Hospital, renewed its contract with Florida Blue in May of this year. The contract renewal includes the termination (effective October 1, 2015) of four Florida Blue Medicare Supplement plans, leaving approximately 4,000 central Florida residents who previously had coverage without...[read more]

Broward Health Agrees to Pay Almost $70M to Settle False Claims Act Allegations - Whistleblower Could Receive More Than $12M

September 25, 2015 by Katie Brant

On September 15, 2015, the Department of Justice (DOJ) announced that Broward Health, an operator of more than 50 health care facilities in South Florida, agreed to pay $69.5 million to settle False Claims Act allegations. Broward Health violated the Federal Stark Law and Anti-Kickback Statute by allegedly overcompensating referring...[read more]

Accountable Care and HealthIT Strategies Summit 2015: Still early days

September 23, 2015 by Elizabeth Zampino

Patients and providers both need to be empowered to deliver on the promises of the Affordable Care Act. That was the major theme and takeaway of the recent “Accountable Care and Health IT Strategies Summit” that I attended a few weeks ago in Chicago. I would add to this sentiment that IT needs help to implement technologies that empower...[read more]

Pill-Mill Crackdown Hurting Patients With Legitimate Pain

September 23, 2015 by Katie Brant

Florida has been plagued for years with the reputation of being the "pill mill capital of the country." Lawmakers needed to do something about prescription painkiller abuse. But, the crackdown on pill mills has produced unintended consequences. Since 2011, there have been strict regulations on doctors and pharmacies when it comes to...[read more]

Financial Assistance for Clinical Trials

September 16, 2015 by Joan Justice

Sometimes hospitals, research centers and pharmaceutical companies will cover the cost of treatment in a clinical trial. However, if the treatment is experimental or investigational, a patient may not receive insurance coverage. Insurance companies generally will cover what is considered the standard of care for a disease.[read more]


Abstinence-only education has failed; let's embrace what works instead

September 14, 2015 by Travis McKnight

It’s unnerving that abstinence-only sex education, which dozens of studies in the last decade prove to be inaccurate, ineffective and harmful, is still the norm for millions of public school students in the United States. We have better options. So why is abstinence only education still taught?[read more]