Money received through the Provider Relief Fund could be at risk as audits ramp up
Recipients of Provider Relief Fund (PRF) distributions and COVID-19 Uninsured Program payments should be girding themselves for audits, legal experts say. The programs represent “a two-front audit fight that providers are facing and will face in the coming years,” Brian Lee, partner with Alston & Bird, said during an Aug. 24 webinar hosted by the…
The evolution of telehealth and the potential for sustainability
The surge in use of telehealth services seen during the pandemic has slowed, but telehealth remains a key modality amid policy changes that will help set the course for the future of virtual care. “There’s no alternative,” said Kyle Zebley, senior vice president for public policy with the American Telemedicine Association (ATA) and executive director…
Prices of drugs for diabetes, heart failure and more will be up for negotiation in Medicare next year
The U.S. Department of Health and Human Services (HHS) on Tuesday announced the first 10 Medicare Part D drugs that will be subject to price negotiations, the headlining healthcare-related provision of the Inflation Reduction Act. Signed in August 2022, the law gave Medicare authority to negotiate with drug manufacturers over the prices of selected drugs.…
No Surprises Act litigation update: QPA methodology deemed illegal as Texas Medical Association wins in court again (updated)
Note: The first section of this article has been updated with the latest news on the status of the arbitration portal. The fourth victory in four cases brought by the Texas Medical Association (TMA) has implications for how insurers calculate the qualifying payment amount (QPA) used to arbitrate out-of-network payment sums under the No Surprises…
Data indicate hospital operational logjams haven’t ceased after the public health emergency (updated)
Note: The fourth section of this article has been updated with news of proposed mandatory staffing ratios for long-term care facilities. Some of the problems that strained hospital operations during the peak of the COVID-19 pandemic have eased, but not enough to mark a true industrywide recovery, a recently released report suggests. Notably, the process…
Children’s hospitals swim against the tide to improve the health of their patients and communities
As the nation’s pediatric hospitals strive to keep kids healthy, they face obstacles that reflect the difficulty of enacting structural changes in care delivery. Even pediatric hospitals that are eager to engage in value-based payment (VBP) models can have a hard time establishing the type of network that allows them to affect the holistic health…
Regulators seek feedback about medical credit cards as potential restrictions loom
A federal request for information signals heightened scrutiny on the issuance of credit cards in healthcare settings. The Consumer Financial Protection Bureau, Department of Health and Human Services and Department of the Treasury sent out an RFI in July to gain stakeholder feedback on whether the widespread availability of medical payment products such as credit…
Congress puts the community benefit standard for nonprofit hospitals under the microscope
The criteria that establish hospitals’ tax-exempt status are coming under closer scrutiny, with a bipartisan quartet of senators asking the IRS to ramp up its oversight of compliance with the community benefit standard. Sens. Bill Cassidy, MD (R-La.), Charles Grassley (R-Iowa), Raphael Warnock (D-Ga.) and Elizabeth Warren (D-Mass.) sent an Aug. 7 letter to the…
FTC and HHS’s Office for Civil Rights put healthcare stakeholders on notice about the use of tracking technology
Federal regulators plan to more rigorously monitor whether tracking technologies on provider websites are impermissibly disclosing consumers’ protected health information (PHI) to third parties in violation of HIPAA. The Federal Trade Commission (FTC) and the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services last month sent a letter to…
Cyberattack leaves hospitals scrambling in several states
A recent attack was the latest to illustrate the potential of cybercriminals to cause havoc across an interstate health system. The Los Angeles-based Prospect Medical Holdings system incurred a ransomware attack Aug. 3 that temporarily required some patients to be diverted from emergency departments and relegated hospitals to using paper records and incorporating other downtime…