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…
CMS proposes to hold Medicare ACOs harmless for spending levels stemming from catheter-billing fraud
CMS has issued a proposed rule to mitigate the impact of a high-profile Medicare fraud scheme on accountable care organizations (ACOs). The rule seeks to address “significant, anomalous and highly suspect billing activity for selected intermittent urinary catheters on Medicare Durable Medical Equipment, Prosthetics, Orthotics & Supplies (DMEPOS) claims” as applied to ACOs in the…
Healthcare providers face Medicare payment-rate penalties for information blocking under new rule
Healthcare providers will receive a lower Medicare payment update if they are deemed to have engaged in information blocking, according to a final rule from HHS and CMS. For hospitals, a violation will leave the organization noncompliant with the Promoting Interoperability Program, meaning it would lose out on three-quarters of the annual market-basket update for…
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…