Tracking Recently Enacted State Laws That Impact the Revenue Cycle
Many bills have been pending in state legislatures. Let’s take a look at what’s been recently enacted in three of those states. … Read More
July 29, 2024
Regulatory Updates
Ideas, insights + industry updates
Revenue Cycle Impacts: 2024 State Legislation
State legislatures have already been busy this year. Here are some topics and bills Ensemble experts have been watching closely. … Read More
April 30, 2024
CMS Tightens Prior Authorization Time Frame in Final Rule
Health plans will be required to meet a prior authorization time frame as short as 72 hours, along with providing reasoning for any denials. … Read More
January 30, 2024
Ensemble’s AI Impact
See how Ensemble is actually applying AI to drive value across the entire revenue cycle. … Read More
January 16, 2024
OIG Increases Scrutiny on Medicare Advantage Coding
Federal agencies are scrutinizing Medicare Advantage coding with inaccurate diagnoses for enrollees with certain high-risk diagnoses. … Read More
October 27, 2023
Clarification of the Two-Midnight Rule: A Win for Physician Advisory
The 2024 Medicare Advantage Final Rule clarifies that Medicare Advantage (MA) plans must follow the Two-Midnight Rule set in 2013, and more. … Read More
October 25, 2023
Congress Investigates OIG Report That Medicaid MCOs Deny Prior Authorizations at Higher Rates
A report from the OIG found some MCOs have unusually high rates of prior authorization denials, with limited or no state oversight. … Read More
October 3, 2023
2024 Medicare Advantage Program Changes: What You Need to Know
This new rule introduces several key changes that will promote transparency and consistency in healthcare coverage decisions. … Read More
July 18, 2023
New Revenue Codes to Be Denied by Cigna Without Corresponding CPT or HCPCS Codes
Cigna added to the list of codes to be denied if billed without a corresponding CPT or HCPCS code starting May 1, 2023. … Read More
May 3, 2023
CMS Final Rule: Changes to the Medicare Advantage Program
Key changes promote transparency in coverage decisions for MA beneficiaries, while ensuring providers can offer the best care for patients. … Read More
May 3, 2023