News

The Centers for Medicare & Medicaid Services (CMS) has announced a new Notice of Funding Opportunity (NOFO) for the Rural Health Transformation (RHT) Program. This $50 billion initiative aims to help states transform rural healthcare. A goal of the RHT program is to spark the growth of innovative care models to improve health outcomes, coordinate care and promote flexible care arrangements. Applications are due November 5, 2025. Read more at https://grants.gov/search-results-detail/360442 .

The HHS Office of the Inspector General has issued a new report - “Medicare Improperly Paid Hospitals an Estimated $79M for Enrollees Who Had Received Mechanical Ventilation.” This is based on 2023 data (typical time discrepancies for these types of federal reports.) In the report , the Office of the Inspector General found that hospitals didn’t fully comply with Medicare requirements for claims with certain Medicare Severity Diagnosis-Related Groups that required more than 96 consecutive hours of mechanical ventilation. This resulted in $79 million in improper payments. On your claims for mechanical ventilation, use the right procedure and diagnosis codes, ...