Legal and Regulatory Compliance

The COVID-19 public health emergency is over: Here’s what healthcare providers should know

An era ends for the U.S. healthcare industry with the termination of the COVID-19 public health emergency (PHE) at the close of the day on Thursday, May 11. The termination means providers are losing many of the federal waivers and flexibilities that have been in place for all or most of the PHE, which took…

Nick Hut May 10, 2023

New data on No Surprises Act arbitration cases show providers are faring well amid systemic challenges

Providers are having success at challenging out-of-network payment amounts under the No Surprises Act, at least when they can get their cases through the arbitration system. CMS published an update showing that between April 15, 2022, when the independent dispute resolution (IDR) portal opened, and March 31, arbitrators issued payment determinations in 42,158 disputes. Initiating…

Nick Hut May 2, 2023

Simon’s ensures the highest recovery rates and adheres to strict compliance standards

Find out how this debt collection services provider ensures its clients are updated on changes in state and federal compliance and law, while also leveraging digital components and maintaining the latest technology.

HFMA April 28, 2023

5 issues that are keeping healthcare compliance professionals up at night

Rarely has the compliance landscape been more muddled or presented more of a challenge for healthcare organizations. “I’ve been a compliance officer for about 20 years now, and I’ve been in healthcare forever,” said Kirsten Wild, RN, a nurse by background who now owns a healthcare compliance consultancy. “But the volume and the pace of…

Nick Hut April 28, 2023

Assessing Reality in Healthcare Financial Information

Healthcare stakeholders, including management, regulators, investors, rating agencies, lenders, media and others seek information to evaluate operating margins and profitability metrics for hospitals and other healthcare organizations. Financial statements, tax/information returns and Medicare cost reports are key information sources for the healthcare industry, but many times they convey seemingly contradictory information, which creates confusion for…

HFMA April 14, 2023

News Briefs: Financial and operational pressures continue for hospitals amid scattered positive signs

Recent financial data for the hospital industry illustrate continuing challenges even as some trends improve. Fitch Ratings released an analysis in early March that offers scant reason for optimism. Titled “Early NFP hospital medians show expected deterioration; will worsen,” it draws on data from hospitals with earlier 2022 financial year-ends. Those numbers show “materially weaker…

Nick Hut March 30, 2023

Creating sound strategies to manage compensation and benefits regardless of where your employees reside

No doubt there are significant cultural and financial benefits to supporting continued remote and hybrid work in healthcare, particularly in billing/coding, call center, scheduling and administrative roles. Healthcare, however, faces specific challenges as they seek to demystify multi-state tax rules.

HFMA March 29, 2023

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.

Deborah Filipek March 23, 2023

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…

Nick Hut February 28, 2023

Hospital price transparency update: Regulatory enforcement soon could become stricter, CMS leaders say

Although nothing is official, CMS leaders indicate enforcement of hospital price transparency regulations is set to become more stringent. For an article published in Health Affairs, the Center for Medicare’s Meena Seshamani, MD, PhD, director, and Douglas Jacobs, MD, chief transformation officer, touted progress that has been made since the rules took effect Jan. 1,…

Nick Hut February 24, 2023
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