Health Plan Payment and Reimbursement

Healthcare News of Note: A majority of physicians fear they missed signs of drug misuse during the pandemic and predict drug overdose deaths will rise, says a Quest Diagnostics report

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Physicians fear they missed signs of drug misuse during the pandemic, improved technology use is seen in patient engagement, and the majority of Medicaid health plans have a health equity plan.

Deborah Filipek December 17, 2021

Hospitals, physicians file lawsuit over the arbitration process in the new surprise billing regulations

Leading provider associations have asked a federal court to halt the incorporation of criteria that appear to favor insurers over providers in an arbitration process to determine out-of-network payment amounts.

Nick Hut December 10, 2021

News Briefs: Federal vaccination requirements finalized for hospitals and most other healthcare settings

If a hospital’s staff aren’t fully vaccinated by Jan. 4, the organization will be deemed noncompliant with Medicare and Medicaid regulations, according to a new federal rule.

Nick Hut November 30, 2021

Healthcare provisions in massive legislation could improve care access but also reduce federal funding for some hospitals

In pending legislation, reductions to disproportionate share hospital payments would be used to subsidize commercial insurance for low-income residents of states that haven’t expanded Medicaid.

Nick Hut November 24, 2021

The pandemic cast a new light on mental health, and telemedicine provided a new avenue to access. How is the industry likely to view mental health and behavioral health in the future?

Dr. Ranga Krishnan of Rush University System for Health discusses the future of mental health payment and practice. He addresses how provider organizations can address workforce shortages by becoming partners in training and by changing the way they provide care to patients. He also talks about improving mental and behavioral healthcare in a value-based payment environment.

Erika Grotto November 16, 2021

Additional requirements are needed to make healthcare price transparency worthwhile, report states

Updates to price transparency regulations should address compliance and formatting and incorporate new data elements.

Nick Hut November 4, 2021

Hospitals and Congress propose improvements to prior authorization processes in Medicare Advantage

The American Hospital Association says pending regulations that would affect prior authorization should be expanded to include Medicare Advantage.

Nick Hut October 22, 2021

Research highlights ways to save more than $250 billion per year through healthcare administrative simplification

Savings can be generated at the organizational and healthcare industry levels through steps to reduce wasteful administrative processes, study authors wrote.

Nick Hut October 22, 2021

Healthcare News of Note: Healthcare insurers owe hospitals billions of dollars in payments and are putting more patients in a bind with retroactive claim denials, says Kaiser Health News

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Insurers are behind in billions of dollars in payments to hospitals, the strain on clinicians and staff grows amid the pandemic, and CFO duties involve more digital activities and investor relations.

Deborah Filipek October 19, 2021

The finalized arbitration process in new surprise-billing regulations appears to favor insurers over hospitals

A new rule establishes a process for resolving payment disputes between health plans and hospitals when regulations on surprise billing begin in 2022.

Nick Hut October 8, 2021
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-leaderboard' ); } );