The courts continue to favor providers in No Surprises Act litigation, this time at the appellate level
After a string of victories in federal district court, a medical association’s success at contesting aspects of the No Surprises Act’s arbitration process recently continued at the appellate level. In an Aug. 2 ruling, the U.S. Court of Appeals for the Fifth Circuit upheld a lower court’s finding that regulations issued in 2022 gave too…
Healthcare Blame Game: Bloomberg Philanthropies puts $250 million into educating new healthcare workers while Patient Rights Advocate spends on spreading misinformation
Chad Mulvany, vice president of federal policy for the California Hospital Association and former HFMA policy director, discusses Bloomberg Philanthropies $250 million investment in the future healthcare workforce, as well as what will actually move the needle on price transparency.
MedPAC takes aim at the Medicare wage index and reiterates support for site-neutral payment
In its semiannual report to Congress, the Medicare Payment Advisory Commission (MedPAC) recommends significant changes to two key aspects of Medicare policy: the wage index and site-neutral payment. 1. A revamp of the wage index The wage index consistently generates concern among healthcare stakeholders, including in Medicare’s FY24 proposed rule for hospital inpatient payments. According…
Medicare’s proposed FY24 update to inpatient payments falls short, hospitals say
Hospitals are less than pleased with Medicare’s proposed FY24 payment update for inpatient care. In proposed regulations, the net inpatient payment update is 2.8% after factoring in a mandatory productivity adjustment of -0.2 percentage points. As usual, the update would be reduced for any hospital that does not fulfill quality-reporting requirements or qualify as a…
Seeking to phase out Medicare DSH payments, MedPAC outlines potential changes to reimbursement for safety net providers
Revamped formulas for hospitals and physicians would be designed to better target payments to providers that treat larger shares of low-income Medicare beneficiaries.
TransUnion Medicare DSH solution helps hospitals identify reimbursement opportunities
Medicare disproportionate share hospital payments payments help serve low-income populations, but comes with a set of challenges such as identifying eligible patients. See one company’s solution by leveraging unique processing and data integration.
Utilization review staff may be hurting results when fixing incorrect inpatient admissions
There's a clear financial winner when choosing a method for correcting an incorrect inpatient admission.
The COVID-19 vaccine mandate for healthcare workers can take effect nationwide, Supreme Court says
The court lifted injunctions that had halted implementation of the COVID-19 vaccine mandate in half the country, leaving hospitals and other affected providers with likely only a few weeks to begin complying.
CMS proposes to restrict Medicare coverage of a high-profile new Alzheimer’s drug
Medicare will pay for use of a new drug to treat Alzheimer’s disease only for patients in approved clinical trials, CMS said in a proposed coverage determination.
CMS cancels regulations that would ensure coverage of breakthrough medical devices, but new legislation could fill the void
Citing patient safety concerns among other issues, CMS formally canceled a Trump administration rule that would have required Medicare to cover breakthrough medical devices.