Healthcare Finance News

The fate of the FTC’s ‘noncompete’ rule appears muddled after early court decisions (updated)

Aug. 20 update: This article has been updated with news that a court has halted the FTC’s rule from taking effect. See the update below. A highly scrutinized rule prohibiting employers from using noncompete agreements has received a mixed reaction in the courts during the leadup to its implementation. Set to take effect Sept. 4,…

Nick Hut August 1, 2024

HFMA recognizes top 9 articles published in hfm, 3 awarded for editorial excellence

HFMA is recognizing the top nine articles published in hfm during FY23-24, with three selected as the winners of the Helen Yerger/L. Vann Seawell Best Article Award for outstanding editorial achievement. Also lauded are the top three runners-up and top three staff-written articles. Myriad topics from increasing adoption and refinement of payer scorecards to using data…

Deborah Filipek July 31, 2024

Appeals court eliminates Medicare supplemental payments for low-wage hospitals (updated-2)

Note: This article was updated most recently Oct. 4 with news that CMS has ended the low-wage-index policy. See that update below. Plaintiff hospitals won litigation last week at the federal appellate level that will adversely affect Medicare payment for some rural hospitals. The U.S. Court of Appeals for the D.C. Circuit backed a district…

Nick Hut July 30, 2024

As providers seek resolution of continuing Change Healthcare issues, UnitedHealth Group reports strong financials

The aftermath of the Change Healthcare cyberattack affected the second-quarter financials of parent company UnitedHealth Group (UHG), but not to the point of hindering the company’s continued “diversified and durable growth,” CEO Andrew Witty said during a recent investor call. Q2 revenues increased by 6% year-over-year, while profits dropped by 5.5% amid costs stemming from…

Nick Hut July 26, 2024

CMS looks to fortify primary care with proposed new codes for advanced care management

With newly proposed regulations, CMS aims to establish coding and payment for services that promote longitudinal relationships between clinicians and patients in primary care. The provisions, part of Medicare’s 2025 proposed rule for physician payments, incorporate new HCPCS G-codes for advanced primary care management (APCM). Three bundles of APCM services would be billable as codes…

Nick Hut July 24, 2024

Massive CrowdStrike crash poses big issues for hospital and clinic operations

July 22 updates With scattered exceptions, hospital and health system operations were largely reported as being back to normal Monday. There were few indications that nonurgent appointments needed to be canceled or diverted, although some organizations warned of the possibility of continued delays. On July 20, Microsoft released a recovery tool that it said would…

Nick Hut July 19, 2024

Medicare’s proposed 2025 rule for physician payments would add to the financial strain facing practices

Medicare’s proposed update to physician payments for 2025 left advocates saying practices will have an increasingly difficult time making ends meet. CMS’s newly proposed rule states that payments are set to be reduced by 2.8% from 2024, based on the change to the conversion factor. The agency explained that it is obligated to implement the…

Nick Hut July 18, 2024

FTC report levies strong criticism at the business practices of pharmacy benefit managers

Vertical integration by pharmacy benefit managers (PBMs), including with providers, is one reason to be concerned about the excessive reach of PBMs in the healthcare industry, according to an interim staff report issued this month by the Federal Trade Commission (FTC). “Due to decades of mergers and acquisitions, the three largest PBMs now manage nearly…

Nick Hut July 17, 2024

A proposed Medicare condition of participation would bring a slew of new requirements for OB care

Note: HFMA’s coverage of the payment update in the outpatient payment proposed rule can be found here. Hospitals intending to participate in Medicare must meet new standards for obstetric (OB) care, according to CMS’s proposed outpatient rule for 2025. The rule proposes to establish a new Medicare condition of participation (CoP), whereby hospitals and critical…

Nick Hut July 12, 2024

Medicare’s proposed outpatient payment update for 2025 doesn’t keep pace with hospital costs, advocates say

Note: Additional coverage of the proposed rule can be found here. Hospital advocates expressed dissatisfaction with the payment update in Medicare’s 2025 proposed rule for hospital outpatient care and ambulatory surgical centers (ASCs). CMS proposes to increase the Medicare rate for outpatient services and ASCs by 2.6%, resulting from a 3% jump in the market…

Nick Hut July 11, 2024
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