2023 regulations for Medicare Advantage and ACA marketplaces seek to enhance network adequacy standards
HHS and CMS recently released sets of 2023 regulations that affect provider network adequacy standards in Medicare Advantage and the Affordable Care Act insurance marketplaces.
Big delays could be in store for early No Surprises Act arbitration cases
The portal for payment arbitration cases taking place under the No Surprises Act is open for business but could be facing a backlog of cases.
IPPS FY23 proposed rule: Tweaks are in store for Medicare’s quality-reporting and pay-for-performance programs
Temporary modifications to two pay-for-performance programs would ensure hospitals don’t face penalties amid the COVID-19 pandemic.
Latest financial metrics for hospitals show reasons for optimism but also persistent challenges
Hospital financial performance partially recovered in March as patient volumes returned to something closer to normal after a significant downturn during the omicron wave.
OIG calls out issues with denials of payment and services in Medicare Advantage
Medicare Advantage processes related to prior authorization hamper beneficiaries’ access to medically necessary care, according to a new report from the HHS Office of Inspector General.
M&A update: A quiet quarter for hospital deal-making reflects the ongoing consequences of the pandemic
Merger-and-acquisition activity among hospitals and health systems remained well under pre-pandemic levels in Q1 2022.
Tentative deal to provide pandemic funding won’t replenish the COVID-19 Uninsured Program
A bipartisan Senate bill would pay for additional vaccines and therapeutics but wouldn’t restore funding to a program that reimburses providers for furnishing COVID-19-related services to the uninsured.
IPPS FY23 proposed rule: CMS seeks to bolster maternal health through a new public-facing hospital designation
Hospitals could attain the “Birthing Friendly” designation by attesting to having implemented best practices in maternal health.
IPPS FY23 proposed rule: Medicare proposes changes to methodology for determining graduate medical education payments to teaching hospitals
The biggest change is an effort to comply with a court ruling on weighted FTE slots, while another change affects sharable slots for certain rural hospitals.
It’s Patient Experience Week: Check out HFMA resources on improving the patient financial experience
The financial experience is an important yet often underappreciated part of the overall patient experience. During Patient Experience Week, there are many simple ways for a healthcare organization to celebrate its revenue cycle team’s accomplishments.