Medicare Payment and Reimbursement

News Briefs: Hospital labor costs rose by almost 40% between 2019 and early 2022

As published in hfm magazine, a monthly roundup of top news for healthcare finance professionals.

Nick Hut May 27, 2022

Hospital prices increasingly are coming under a microscope

Newly issued reports and policy recommendations are examining hospital prices in the context of high healthcare costs.

Nick Hut May 20, 2022

Hospitalists are more likely than other physicians to choose high-intensity codes for inpatient care, study finds

The billing and coding practices of hospitalists may contribute to the rising cost of hospital care in the U.S., according to conclusions of a new study.

Nick Hut May 18, 2022

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.

Nick Hut May 17, 2022

2023 regulations for Medicare Advantage and ACA marketplaces seek to enhance network adequacy standards

HHS and CMS recently released sets of 2023 regulations that affect provider network adequacy standards in Medicare Advantage and the Affordable Care Act insurance marketplaces.

Nick Hut May 9, 2022

IPPS FY23 proposed rule: Tweaks are in store for Medicare’s quality-reporting and pay-for-performance programs

Temporary modifications to two pay-for-performance programs would ensure hospitals don’t face penalties amid the COVID-19 pandemic.

Nick Hut May 5, 2022

OIG calls out issues with denials of payment and services in Medicare Advantage

Medicare Advantage processes related to prior authorization hamper beneficiaries’ access to medically necessary care, according to a new report from the HHS Office of Inspector General.

Nick Hut April 29, 2022

Tentative deal to provide pandemic funding won’t replenish the COVID-19 Uninsured Program

A bipartisan Senate bill would pay for additional vaccines and therapeutics but wouldn’t restore funding to a program that reimburses providers for furnishing COVID-19-related services to the uninsured.

Nick Hut April 27, 2022

News Briefs: Biden administration will apply closer scrutiny to healthcare billing practices

A monthly roundup of top news for healthcare finance professionals.

Nick Hut April 27, 2022

IPPS FY23 proposed rule: CMS seeks to bolster maternal health through a new public-facing hospital designation

Hospitals could attain the “Birthing Friendly” designation by attesting to having implemented best practices in maternal health.

Nick Hut April 26, 2022
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-leaderboard' ); } );