Healthcare News of Note: Medicare to negotiate reduced prices for 40 drugs by 2028, says study
Medicare drug price negotiation has the potential to benefit Medicare beneficiaries across some of the most common disease states.
News Briefs: Healthcare industry disrupter CVS Health to shell out billions to buy Oak Street Health
A month after stating it hoped to gain a presence in primary care, CVS Health accomplished that goal with a massive deal that could fortify its efforts to advance value-based payment in healthcare. The proposed $10.6 billion acquisition of Oak Street Health, a provider of senior-focused primary care, adds to a portfolio of assets that…
OIG describes how hospitals can use NPs to treat patients without violating the Anti-Kickback Statute
An advisory opinion from the HHS Office of Inspector General (OIG) appears to give hospitals leeway to expand their use of nurse practitioners in specific situations without violating the Anti-Kickback Statute. OIG issued the opinion in December in response to an inquiry from an unnamed acute care hospital. The hospital was seeking clarification on whether…
News Briefs: 2023 brings a steep fee hike for No Surprises Act arbitration cases
The No Surprises Act’s independent dispute resolution (IDR) process has become more expensive for healthcare stakeholders. For the new year, the nonrefundable administrative fee due from each party involved in any payment dispute that goes to arbitration increased from $50 to $350, according to a Dec. 23 memo from CMS’s Center for Consumer Information and…
Medicare contractors should more closely examine providers’ bad debt claims, HHS watchdog says
Medicare administrative contractors (MACs) soon could apply more scrutiny to providers’ reported bad debts if CMS implements recommendations from the HHS Office of Inspector General (OIG). OIG in December issued a report in which it examined bad-debt reimbursement claims on Medicare cost reports spanning 2016 through 2018 for 67 randomly selected providers (including 29 hospitals). In those…
Healthcare News of Note: Advocate Aurora Health and Atrium Health megamerger complete
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Atrium and Advocate Health close merger deal, CMS details expectations of hospitals in memo addressing workplace violence, and CMS plans to recoup $650 million in overpayments to Medicare Advantage plans.
New rule sets forth proposed Medicare payment policies for rural emergency hospitals
For hospitals that choose to begin operating under the new rural emergency hospital designation in 2023, Medicare will pay for any service that would be covered as a hospital outpatient department service.
Medicare spells out proposed conditions of participation for rural emergency hospitals
Seeking to shore up operations for rural hospitals, CMS issued a proposed rule that establishes recommended regulations for the new rural emergency hospital category.
Some Medicare payments to hospitals for bariatric surgery may be inappropriate, OIG finds
Medicare could have saved nearly $48 million in bariatric surgery payments to hospitals during an 18-month period if coverage rules and guidance were better implemented at the contractor level, according to the HHS Office of Inspector General.
As COVID-19 vaccination deadlines arrive for healthcare providers, CMS offers explanatory resources
As the deadlines arrive for providers to comply with the COVID-19 vaccine mandate, CMS has made various resources available to help healthcare entities determine whether and when the regulations apply to them.