No Surprises Act end-of-year update: A new administrative fee is set, and the arbitration portal is fully functional
Bringing out-of-network payment disputes to arbitration under the No Surprises Act in 2024 will be less expensive than previously described. In a final rule, the U.S. Departments of Health and Human Services (HHS), Labor and Treasury set the administrative fee for using the independent dispute resolution (IDR) portal at $115 per case, effective 30 days…
Healthcare News of Note: What topics did healthcare finance professionals find of most interest in 2023?
Workforce issues drew the most engagement in HFMA’s Healthcare News of Note blog Three of the 10 most-read Healthcare News of Note blog posts of 2023 were workforce-related, making it the No. 1 topic sparking blog readers’ interest. Those stories were: 7 stories round out the top 10 of 2023 Additional topics that piqued reader…
HFMA strategy session highlights challenges and opportunities for healthcare finance leaders: payer relations, supply costs, AI and more
The legacy healthcare provider’s position in the industry could grow tenuous if leaders don’t respond boldly and strategically to ongoing trends, according to insights recently presented to HFMA leaders. “We’re at a crossroads right now,” Ashraf Shehata, principal and U.S. national sector leader for healthcare and life sciences with KPMG, said in November during a…
New data on national healthcare spending highlights the constraints facing hospitals
Recently published 2022 data indicates relatively restrained national healthcare spending as the COVID-19 pandemic faded, especially in the hospital sector. The increase in spending on hospital services slowed from 4.5% in 2021 to 2.2% in 2022, CMS actuaries reported Dec. 13 in Health Affairs. The increase was significantly less than in 2020 (6.2%) and the…
House passes bill to codify healthcare price transparency, expand site-neutral payment
The hospital industry saw reason for both relief and disappointment this week after a bill designed to promote price transparency took a major step toward becoming law. The House on Dec. 11 passed H.R. 5378, also known as the Lower Costs, More Transparency Act, by a 320-71 vote. Along with cementing price transparency as the…
News Briefs: Medicare’s hospital outpatient payment rate for 2024 improves marginally from the proposed rule
The final rule setting Medicare’s 2024 payment rates and policies for hospital outpatient services and ambulatory surgical centers (ASCs) contained little to make hospitals optimistic about the government portion of their payer mix. Base payments for items and services furnished in hospital outpatient settings and ASCs will increase by 3.1% after factoring in the usual…
Moody’s sees potential positive RCM impact from AI
Ratings agency Moody’s Investors Service has joined other industry players in identifying ways artificial intelligence can create efficiencies in revenue cycle management. The growing use of the technology potentially could bring accounts receivable balances down and minimize write-offs of past-due balances, according to the three authors of a report published in the company’s “Healthcare Quarterly”…
With a new rule, CMS looks to crack down on states’ Medicaid disenrollment processes
In its latest effort to stem the ongoing wave of Medicaid disenrollments, CMS issued regulations describing its authority to penalize states for disregarding federal guidelines pertaining to the end of continuous-enrollment requirements. Published Dec. 6 in an interim final rule with comment period, the regulations took effect immediately and were based on provisions passed by…
Key Senate committee takes a close look at healthcare waste and prices
The U.S. Senate is intent on finding ways to improve the value of healthcare, according to takeaways from a recent hearing of the Budget Committee. Although other committees and subcommittees in both chambers of Congress have held meaningful hearings about healthcare policy and costs this year, the Budget Committee’s attention to the matter is especially…
Pharmacy transparency: a rising trend in the industry
After publishing my Nov. 29 blog, which delved into Cost Plus Drugs’ expansion into the specialty drug market, CVS Health revealed plans to streamline its pricing and sales approach for pharmaceuticals in retail pharmacies. This move by the pharmacy giant, which operates approximately 9,500 retail pharmacies, involves simplifying the reimbursement process for these pharmacies. The…