News

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

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…

Nick Hut July 9, 2024

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…

Nick Hut July 3, 2024

HFMA recognized by multiple organizations for exceptional education, editorial and website

The Healthcare Financial Management Association (HFMA) has received numerous awards for its innovative educational program, editorial content and high-quality website.

Deborah Filipek July 2, 2024

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…

Nick Hut June 28, 2024

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…

Nick Hut June 27, 2024

Healthcare Financial Management Association Recognizes Center for Medicare and Medicaid Innovation Director Elizabeth Fowler for Contributions to Healthcare

(Las Vegas) June 27, 2024 — The Healthcare Financial Management Association (HFMA) presented its highest achievement award, the Richard L. Clarke Board of Directors Award, to CMS Deputy Administrator and Director of the Center for Medicare and Medicaid Innovation (CMS Innovation Center) Elizabeth Fowler, Ph.D., J.D., today during HFMA’s annual conference in Las Vegas. The…

HFMA June 27, 2024
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