Supreme Court ruling on Chevron makes regulations in healthcare (and other industries) more vulnerable to legal challenges
The U.S. Supreme Court issued a decision Friday that has dramatic implications for the regulatory infrastructure in healthcare, among many other industries. Since it was established in a 1984 case, Chevron deference has served as guidance to courts that regulatory authorities such as CMS and dozens of others across the federal government have license to…
Annual Conference Day 4: Geeta Nayyar discusses information gaps and the promise and perils of technology
Applications of technology and the purveyance of information are key issues impacting the efficacy of the healthcare system, author and healthcare technology expert Geeta Nayyar, MD, MBA, explained during Thursday’s keynote session in Las Vegas. In a sit-down discussion with HFMA President and CEO Ann Jordan, Nayyar described working at the intersection of medicine and…
Annual Conference Day 3: UnitedHealth, Optum executives discuss resilience strategies for healthcare
Especially after being on the front lines of the most impactful cyberattack to hit the healthcare industry, leaders with UnitedHealth Group (UHG) and Optum have plenty of thoughts on how stakeholders can shore up their defenses. UHG is the parent company and Optum a sister company of Change Healthcare, which was the target of a…
Annual Conference Day 2: Keynote speaker Suneel Gupta expounds on the importance of recharging
Rest and breaks from work should be viewed not as a reward, but as a resource that supports performance, Suneel Gupta, wellness CEO, best-selling author and visiting scholar with Harvard Medical School, told HFMA Annual Conference attendees during Tuesday’s keynote presentation in Las Vegas. “When we look at the science behind human performance, what we…
Annual Conference Day 1: HFMA, AHA leaders hold forth on the state of the healthcare industry
HFMA’s 2024 Annual Conference began Monday afternoon with HFMA’s Ann Jordan and the American Hospital Association’s Rick Pollack rallying attendees to address the profound challenges and opportunities facing the industry. To start, Jordan, HFMA’s president and CEO, highlighted the conference theme, “A New Frontier in Health.” Frontier is “an exciting and unsettling word that really…
Preventive-services coverage mandate for Affordable Care Act plans remains intact following appeals court ruling
In a decision that could have been consequential for health insurance coverage offered through the Affordable Care Act (ACA) marketplaces, an appeals court limited the immediate impact. The U.S. Court of Appeals for the Fifth Circuit upheld a lower-court ruling that preventive-care mandates for ACA health plans are unconstitutional. But the appeals court said the…
Proposed rule to halt credit-reporting of medical debt would have big ramifications for hospitals and other providers
A proposed rule from the Consumer Financial Protection Bureau (CFPB) would curtail the inclusion of medical debt in credit evaluations, potentially shaking up healthcare billing and collections processes. The CFPB framed part of its rationale for the rule in the context of privacy, noting Congress previously limited the sharing of a patient’s medical information in…
Health system success depends on effective integration of APPs
Effectively leveraging advanced practice providers (APPs) within a health system’s ambulatory and inpatient settings can improve patient access and throughput and support volume growth. APPs have a rapidly growing presence within the clinical workforce. Consider these statistics: With median salary and fringe benefits for APPs approaching $200,000 a year, health system leaders can no longer…
CMS’s 2024 MA rule brings some improvements but falls short of addressing all providers’ concerns
Hospitals and other healthcare providers welcomed CMS’s release in 2023 of the 2024 Medicare Advantage and Part D final rule (CMS-4201-F).a The rule represents CMS’s effort to refine the practices of MA organizations by placing limitations on prior authorization, elevating requirements for provider directories and making comprehensive adjustments to the MA and Part D quality…
Congress seeks to keep the momentum going on improvements to prior authorization
Members of Congress are revitalizing efforts to pass legislation that would streamline prior authorization in Medicare Advantage (MA). A bipartisan, bicameral group of legislators reintroduced the Improving Seniors’ Timely Access to Care Act, a bill that unanimously passed the House in September 2022 but did not receive a vote in the Senate. One obstacle at…