A Pennsylvania health system filed suit this week against Aetna, challenging a policy around "downcoding" that has drawn ire ...

Inpatient encounters for Medicare patients 65 years and older are associated with higher coding intensity compared with commercially insured, Medicaid, or self-pay hospitalizations for those same ...

After pushback from prominent provider organizations, Aetna is easing a controversial "downcoding" policy for inpatient Medicare Advantage claims. The insurer said in an updated notice late last week ...

The health system claims the policy, which reduces reimbursement for some inpatient hospital stays, violates federal law and ...

There are currently around 1,740 procedures on CMS’ inpatient only list, which is reviewed and updated annually. However, CMS proposed eliminating the inpatient only list in 2021 after years of ...