Hospitals will get only a small bump in Medicare inpatient payments for FY25
Hospital representatives were less than excited about the rate update in Medicare’s FY25 final rule for inpatient care and long-term care hospitals. Published Aug. 1, the rule includes a 2.9% rate increase for acute care hospitals in the fiscal year that begins Oct. 1. The increase is derived from a 3.4% hike in the market…
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,…
Ramifications of a proposed rule to halt credit reporting of medical debt
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 June 11 rule in the context of privacy, noting Congress previously limited the sharing of a patient’s medical…
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…
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…
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…
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…
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…
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…
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…