Med Learn
MedLearn Publishing, a division of MedLearn Media, Inc., is a nationally recognized healthcare publishing and media firm specializing in all aspects of coding, compliance, reimbursement and the revenue cycle. For more than 30 years, MedLearn Publishing has delivered actionable answers that equip healthcare organizations to confidently meet their revenue and compliance obligations. Our clients access this information through a variety of resources, including publications, newsletters, and webcasts.
MedLearn is dedicated to fighting Non-Patient Outcome Spending (NPOS), especially in the areas of billing and compliance. NPOS is the sum of all non-frontline portions of hospital and clinic operations. You can count on us to walk you through recent and upcoming developments in niche coding, compliance and reimbursement— regardless of how complex and overwhelming they may seem. Our experts constantly watch the horizon for what’s coming, carefully research how you’ll be impacted, and articulate the steps required to keep your facility compliant and fiscally strong in a variety of settings. Source
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Recent Articles
Search ArticlesDo We Really Want a “Doc in the Loop” as AI Policy?
As we know, a basic rule of thumb for use of artificial intelligence (AI), at least in this phase of its evolution, is that you should always have a human in the loop. AI makes mistakes, makes things up, tries to please you, and sometimes hallucinate. My Alexa at home keeps calling me the wrong name. So, the thinking is, you’ve got to keep a human in the loop.
Many Hot Issues: PEPPER, “Readmissions,” and Appeal Frustrations
Lots of topics for today. First, last week I was discussing a hospital’s Program for Evaluating Payment Patterns Electronic Report (PEPPER) results with them and noted that they were a high outlier for one-day inpatient admissions. Their number was small, but nonetheless, they exceeded the 80th percentile.
The Single Payer Healthcare System: Coming Soon or?
It feels to me that like the proverbial lobster in the pot, we may be failing to notice a rapid approach of a single-payer system because it is happening in a very subtle manner. We have had many articles discussing how the price transparency regulation requires hospitals to list all their reimbursements for every code. But there haven’t been as many discussing the fact that the price transparency rules also require insurance companies to post every reimbursement they provide for every code.
Worksheet S-12 and the Future of Medicare Reimbursement
Today I want to focus on a change that many hospitals may have overlooked. The Centers for Medicare & Medicaid Services (CMS) recently inserted a new schedule into the Medicare cost report called Worksheet S-12. At first glance, it looks like just another reporting requirement. But it’s much bigger than that. In fact, I believe Worksheet S-12 is the first visible sign of what could become the biggest change to Medicare inpatient reimbursement that most of us will see in our careers.
Talk Ten Tuesdays Celebrates 700th Live Broadcast, Marking a Milestone in Healthcare Coding Education
Special Commemorative Episode Airs July 28, 2026 INVER GROVE HEIGHTS, Minn., July 22, 2026 /PRNewswire-PRWeb/ — Talk Ten Tuesdays, ICD10monitor’s premier weekly healthcare podcast, will celebrate its 700th live broadcast on Tuesday, July 28, 2026, commemorating nearly two decades of trusted education, expert analysis, and industry leadership.
Has The Pendulum Swung Too Far Towards Quality?
A couple of years ago, I worked with ICD10monitor cohost Penny Jefferson on a project about admission type and how it impacts performance on quality measures. That data gap is one of the biggest takeaways from the project: the lack of cohesion among measure requirements and data elements that lets some hospitals outperform their peers on paper without necessarily providing better health outcomes.
Billing, Bad Actors, and Big Consequences: The HIM Role in Behavioral Health Compliance
Recent federal enforcement actions show one clear trend: behavioral health agencies are now among the most heavily scrutinized entities in U.S. healthcare fraud investigations. Earlier this month, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) published its Semiannual Report to Congress, highlighting a wave of enforcement actions totaling more than $5.5 billion in monetary impact.
From Voluntary to Mandatory: CMS Is Rewiring eCQMs and dQMs
The Centers for Medicare & Medicaid Services (CMS) is adding another electronic clinical quality measure (eCQM) to the hospital reporting portfolio, but the story doesn’t end there.
The IPO List Continues to Disappear
The 2027 Outpatient Prospective Payment System (OPPS) Proposed Rule has listed the intent to remove an additional 637 procedures from the Inpatient-Only (IPO) List as the second phase of its three-year elimination strategy. The Centers for Medicare & Medicaid Services (CMS) stated several times in the ruling that they are leaving only the most clinically complex services for removal in 2028.
An IPPS Preview – Proposed MS-DRG Changes
July is coming to an end, so that means there are hopefully only a few days until we get the Inpatient Prospective Payment System (IPPS) Final Rule. That’s also just enough time to take a look at a couple of the proposed Diagnosis-Related Group (DRG) changes. The first one is in MDC 05, Diseases and Disorders of the Circulatory System, and deals with cardiac pacemaker revisions and replacements.