For the No Surprises Act arbitration process, 2023 brings a steep fee hike and continuing litigation
The No Surprises Act’s independent dispute resolution (IDR) process is about to become more expensive for healthcare stakeholders. In 2023, the nonrefundable administrative fee due from each party involved in any payment dispute that goes to arbitration will increase from $50 to $350, according to a Dec. 23 memo from CMS’s Center for Consumer Information and Insurance…
Healthcare News of Note: More than 3,500 deaths in the US attributed to long COVID during a 30-month period
For a 30-month period beginning in January 2020, long COVID played a part in the deaths of 3,544 people, according to a report by the CDC’s National Center for Health Statistics. The Department of Justice has support from hospital advocates as it looks to appeal a court ruling that allowed UnitedHealth Group to acquire Change…
New federal rule aims to eventually ease prior authorization processes
CMS is seeking to improve the prior authorization process in government programs such as Medicare Advantage (MA) and Medicaid, although the core provisions would not begin until 2026. The agency this week updated a Trump administration proposed rule with new proposals to “improve patient and provider access to health information and streamline processes related to prior authorization…
HHS says the co-provider requirement for good-faith estimates is being tabled indefinitely
The U.S. Department of Health and Human Services has given hospitals and other healthcare providers a break on enforcement of a looming requirement for co-providers to be included on good-faith estimates (GFEs) furnished to uninsured patients. HHS announced in an updated FAQ that it will continue to exercise “enforcement discretion” instead of potentially penalizing providers starting Jan.…
CareCredit healthcare credit card provides flexible payment options for both patients and healthcare providers
Read about one company's payment solution that gives patients a way to pay for out-of-pocket healthcare costs while enabling health care organizations to receive payment for services within two business days.
No Surprises Act regulations remain a moving target for compliance
Amid all the rules stemming from the No Surprises Act, a looming mandate for providers to send cost estimates to health plans looks like the biggest stress inducer.
Healthcare News of Note: UnitedHealth Group can proceed with Change Healthcare purchase after a favorable decision in an antitrust case
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: UnitedHealth Group cleared to acquire Change Healthcare, standard patient satisfaction surveys need to address DEI issues, and homebound older adults contribute to higher levels of Medicare spending.
Surprise-billing arbitration updates include a lawsuit and new context on rate-setting approaches
A provider association that earlier won a lawsuit over the No Surprises Act arbitration process is going to court again over the same issue.
Hospitals issue plea for healthcare policymakers to do more to buttress the industry
The American Hospital Association and hospital leaders say recent financial trends are unsustainable for many organizations.
PMMC’s Contract PRO helps hospitals see an average 10 to 1 ROI
When the time comes to renegotiate payer contracts, one company’s contract management system “provides managed care leaders with the ability to model all commercial payer contract terms to quickly understand the impact on net revenue.”