Joseph Zebrowitz, MD

By Joseph Zebrowitz, MD Denials Are Bad…Maybe Not One of the central tenets of utilization management is that “denials are bad.” Our hospitals have developed a myriad of Key Performance Indicators (KPIs) that reflect this: we track denial rate and total number of...

Much ado is being made about the addition of Total Knee Arthroplasty (TKA) to the Program for Evaluating Payment Patterns Electronic Report or, as we all know it, the PEPPER. I would add my voice to the “ado,” not because I think this indicates coming scrutiny, but...

These waivers, known as 1135 waivers (due to being granted by Section 1135 of the Social Security Act), are allowed when 2 conditions are met: First, there must be a declaration of a Public Health Emergency (PHE) by the Secretary of the Department of Health and Human...

The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) issued separate announcements last week that I think will interest you.  HHS Updates HHS announced two additional distributions from the Coronavirus Aid,...