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Author Archives: PCG Software

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Aug52021

Higher and Faster Growing Spending Per Medicare Advantage Enrollee Adds to Medicare’s Solvency and Affordability

BlogAugust 5, 2021

The following information appeared on, kff.org The Kaiser Family Foundation prepared an excellent review of the rising costs of the…

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Aug12021

Preparation for Appropriate Use Criteria is Key to Success

BlogAugust 1, 2021

The following information appeared on, CMS.gov The delay of the implementation of the AUC is over. Beginning January 1, 2022,…

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Jul302021

Government Intervenes in False Claims Act Lawsuits Against Kaiser Permanente Affiliates for Submitting Inaccurate Diagnosis Codes to the Medicare Advantage Program

BlogJuly 30, 2021

The following information appeared on, Justice.gov Department of Justice Press Release—Friday, July 30, 2021 “The United States has intervened in…

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Jul262021

Da Vita, Inc. and Former CEO Indicted in Ongoing Investigation of Labor Market Collusion in Health Care Industry

BlogJuly 26, 2021

The following information appeared on, Justice.gov In the July 15, 2021, DOJ press release, the Denver Grand Jury has indicted…

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Jul222021

Major Changes in the Inpatient Only Procedure Listing

BlogJuly 22, 2021

The following information appeared on, CMS.gov On December 2, 2020, the Centers for Medi-care & Medicaid Services (CMS) finalized policies…

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Using the KU Modifier for Wheelchair Accessories and Seat Back Cushions, Date Extended

BlogJuly 22, 2021

The KU modifier is used to receive the unadjusted fee schedule amount and was implemented for a variety of wheelchair…

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