HHS: Insurers won’t be penalized if they don’t update their No Surprises Act qualifying payment amounts as required
Providers may not immediately benefit from a favorable court ruling that affects the methodology for determining the qualifying payment amount (QPA) under the No Surprises Act. The U.S. Department of Health and Human Services (HHS) issued guidance Oct. 6 that says the Biden administration will not enforce the court decision until at least May 1.…
Insights on population health management challenges through the eyes of C-suite leaders
Population health management is at a crossroads, and one key to ensuring its viability is to bolster stakeholder trust in the potential of value-based payment (VBP) models. That was a key takeaway from healthcare executives who took part in a September panel discussion at the 23rd annual Population Health Colloquium, hosted by the Jefferson College…
HFMA opens nominations for key volunteer leadership roles
Every year, HFMA seeks volunteers who want to take an active role in leading the financial management of healthcare by serving on a key HFMA advisory council or committee. Now that the Association has grown to more than 100,000 members, there has never been a better time to help shape the future of the healthcare…
Update: Medicaid DSH payment cut averted as House, Senate pass short-term federal funding
Note: The headline and lead section of this article were updated Oct. 1 with news of a six-week government funding extension that delays the Medicaid DSH cuts and pays for other healthcare programs. The article originally was published Sept. 28 under the headline, “An $8 billion Medicaid DSH cut is closer to happening as a…
Maryland Chapter event focuses on inclusion and equity
There’s growing demand on the healthcare industry to close disparity gaps and ensure health equity. But hospitals and health systems can’t do it alone. Collaboration and partnerships are necessary. And that was the impetus behind the HFMA Maryland Chapter’s 2023 Inclusion and Equity in Healthcare Conference, which took place April 27 at the Reginald F.…
CMS pressures states to restore Medicaid coverage for some beneficiaries who have been disenrolled
CMS says a recent edict to state Medicaid programs has partially stanched the ongoing wave of disenrollments in the program, with about 500,000 beneficiaries set to regain coverage they had lost and “many” others protected from disenrollment going forward. As described in a Sept. 21 summary, 29 states plus Washington, D.C., have acknowledged a systemic…
HHS sets new administrative fee to be paid by parties in No Surprises Act independent dispute resolution cases
Oct. 6 update: The lead section of this article was updated where noted with news about the arbitration portal. The administrative fee for taking out-of-network payment disputes to arbitration under the No Surprises Act in 2024 would be significantly lower than it was for much of 2023, but triple the current rate, according to proposed…
As clock ticks toward massive Medicaid disproportionate share hospital cuts, proposed bill would bring relief
A congressional bill that would impose additional transparency requirements on providers also would offer a respite from a sizable cut to a key supplemental payment. A $32 billion reduction to Medicaid disproportionate share hospital (DSH) payments is scheduled to span four years, beginning when federal FY24 gets underway Oct. 1. The Lower Costs, More Transparency…
Legislation to enhance healthcare pricing and billing transparency takes a big step forward in the House
A slew of provisions on healthcare transparency took a step closer to becoming federal law as three House committees last week merged separate bills into a single draft. The resulting bill is just about set for consideration by the full House, where bipartisan support for the major provisions was apparent in the committee phase. The…
Published data quantify how cost increases will continue to affect the healthcare industry next year
The cost to treat patients will accelerate next year, with ramifications across the healthcare industry, according to newly published projections. PwC’s Health Research Institute reported that the cost of providing care will increase by 7% in 2024, up from a 6% increase this year and 5.5% in 2022. A 7% increase would tie 2021 for…