Blog

What is the RCD? The Review Choice Demonstration (RCD) project for Inpatient Rehabilitation Facilities (IRF) seemed like a pipe dream when the Centers for Medicare & Medicaid Services (CMS) started discussing it before the Pandemic. The goal of the RCD is to reduce the burden on providers demonstrating compliance with Medicare IRF rules.  The RCD started out slowly, but is currently in full swing in four states: Alabama (effective August 2023) Pennsylvania (effective June 2024) Texas

Glucagon-Like Peptide-1 (GLP-1) medications have largely been discussed as a pharmaceutical and clinical story. Increasingly, however, they are becoming a healthcare strategy story. A recent Wells Fargo analysis highlighted by Fierce Healthcare suggests that widespread GLP-1 use could disrupt a healthcare system that has historically invested significant resources in treating the downstream consequences of obesity (Fierce Healthcare, 2026). As treatment moves further upstream, healthcare organizations may need to reconsider everything from service-line projections and utilization

Another day, another False Claims Act (FCA) allegation—and this time, it’s a big one.   The U.S. Department of Justice (DOJ) announced a healthcare provider agreed to a settlement exceeding $541 million to resolve allegations that unsupported diagnosis codes were submitted to Medicare Advantage Organizations, resulting in inflated payments from the Medicare program. According to the DOJ, the alleged conduct involved diagnosis codes that lacked sufficient documentation in the medical record or were based on improper