Medicare Payment and Reimbursement

GAO report examines how pass-through status affects Medicare payments for drugs used in outpatient care

A Government Accountability Office report finds that Medicare pays more to cover drugs used in hospital outpatient settings when pass-through payment status is in effect.

Nick Hut March 6, 2021

Healthcare News of Note: Trump administration diverted nearly $10 billion in funds slated for hospitals to Operation Warp Speed

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles, including the discovery that provider funds were used for Warp Speed operations, the need to retain the Medicare telehealth expansion and healthcare antitrust issues to watch.

HFMA March 4, 2021

After OIG says hospitals may be engaging in upcoding, CMS and AHA dispute the finding

The HHS Office of Inspector General says a significant rise in high-severity inpatient admissions with no corresponding increase in length of stay indicates a possible pattern of upcoding by hospitals in recent years.

Nick Hut March 2, 2021

Navigating change: Implications of CMS’s 2021 Physician Fee Schedule

Changes to the CMS Physician Fee Schedule for 2021 require immediate deliberation by provider organizations with respect to how they will structure their physician compensation arrangements.

Patty Bohney, CVA, MBA February 19, 2021

Hospital groups ask Supreme Court to reverse payment cuts to 340B hospitals, off-campus provider-based departments

The American Hospital Association and other hospital groups are challenging 2020 appeals court decisions that allow HHS to continue slashing payments to 340B hospitals and to off-campus provider-based departments.

Nick Hut February 16, 2021

Is the Medicare Appeals Backlog Finally Breaking?

Facing a court order to eliminate its Medicare appeals backlog, the Trump administration has seen early success.

Rich Daly February 12, 2021

Significance of ACO Departures Downplayed by Industry Analysts

Industry analysts downplayed the recent revelation that 74 Medicare accountable care organizations (ACOs) left the program at some point in 2018.

Rich Daly February 12, 2021

Medicare Expansion Proposals Draw Hospital Concerns

Hospital advocates are increasingly voicing opposition to various Medicare expansion proposals over concerns about their adverse financial impacts.

Rich Daly February 12, 2021

Panel: How the healthcare industry can achieve a higher-value and more equitable system

A panel of experts explored how to make healthcare more effective both generally and for underserved demographics specifically.

Nick Hut February 1, 2021

Healthcare News of Note: Report indicates uptick in hospital M&A activity

Healthcare News of Note for healthcare finance professionals is a roundup of articles from the past week, including more M&A activity in Q4, an extension of the COVID-19 PHE underway and FTC examination of claims data to help assess impact of physician group consolidation.

Deborah Filipek January 29, 2021
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