Key points to know in recently proposed rules for Medicare Advantage and the ACA marketplaces
A proposed rule for health plans in Medicare Advantage has provisions designed to stem overreach in prior authorization processes.
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.
Remedies for 340B underpayments remain up in the air after court declines to provide guidance
A federal court is allowing HHS to decide on remedies covering Medicare underpayments to hospitals for 340B drugs.
Healthcare News of Note: What healthcare sector innovations are consumers most excited about?
Some 48% of healthcare consumers surveyed said improved insight into how much care would cost was the No. 1 item they were excited about when it came to innovation in healthcare. Employers can expect an increase of more than 20,000% in adolescent mental health telehealth costs, according to a study showing telehealth appointments cost an…
Medicare contractors should more closely examine providers’ bad debt claims, HHS watchdog says
Medicare administrative contractors (MACs) soon could apply more scrutiny to providers’ reported bad debts if CMS implements recommendations from the HHS Office of Inspector General (OIG). OIG in December issued a report in which it examined bad-debt reimbursement claims on Medicare cost reports spanning 2016 through 2018 for 67 randomly selected providers (including 29 hospitals). In those…
Beyond the News: Nick and Shawn discuss No Surprises, disruptors and everything else that made healthcare industry headlines in 2022
HFMA Senior Editor Nick Hut and HFMA Policy Director Shawn Stack discuss the top stories of 2022 in this special year-end episode.
FY 2023 Hospice Wage Index and Payment Rate Update Final Rule Summary
HFMA provides a detailed summary of the final rule updating the Medicare hospice payment rates for fiscal year 2023.
Massive federal spending bill alleviates reimbursement concerns for hospitals, but less so for physicians
Healthcare provider advocates applauded the inclusion of key reimbursement relief measures and other policies in a proposed federal spending bill for FY23, although physician groups expressed concern about the outlook for their constituents. With a divided Congress looking to muster the votes to pass the legislation before a self-imposed deadline of week’s end, the bill includes many…
A “spicy” lame duck session for the 117th Congress and other things to expect after midterm elections
Friend of the podcast Chad Mulvany of the California Hospital Association joins HFMA Policy Director Andrew Donohue and Senior Editor Nick Hut in a discussion about what midterm elections could mean for healthcare.
Prior Authorization and Interoperability for Medicare Advantage, Medicaid, CHIP, and QHPs Proposed Rule Summary
HFMA presents a detailed summary of the proposed rule designed to improve the electronic exchange of health care data and streamline prior authorization processes, while continuing to encourage interoperability in the healthcare market.