Medicare Payment and Reimbursement

Hospital groups express concern over earlier court ruling that could expand False Claims Act liability

The groups argue that allowing FCA claims to be brought for post-termination actions would defy congressional intent and leave hospitals subject to excessive financial liability.

Nick Hut October 19, 2021

With substantial Medicare payment cuts pending, medical groups call for Congress to act

Payment cuts scheduled for 2022 would amount to a 9.75% reduction in Medicare revenue for medical groups, which are calling on Congress to pass legislation to stop the cuts.

Nick Hut October 14, 2021

The stakes are only growing in efforts to improve the cost effectiveness of health, CMMI’s Elizabeth Fowler says

The head of the Center for Medicare & Medicaid Innovation spoke with an HFMA audience about the importance of efforts at the federal level and beyond to improve the cost effectiveness of health.

Nick Hut October 6, 2021

After a long wait, HHS sends out details on the next Provider Relief Fund distributions

The U.S. Department of Health and Human Services announced $25.5 billion in upcoming distributions from the Provider Relief Fund.

Nick Hut September 28, 2021

Site-of-care payment issues get highlighted by UnitedHealthcare and MedPAC

A new report issued by a leading health plan is the latest sign that hospitals and health systems can expect payers to ramp up implementation of site-neutral payments.

Nick Hut September 27, 2021

Why responding to site-neutral payment risk is imperative for hospitals and health systems

As the likelihood of site-neutral payments increases over a range of services, hospitals and health systems must understand which services are most at risk from these changes and determine how quickly they will respond.

Dawn Samaris, MBA September 27, 2021

Recipients of COVID-19 vaccine boosters won’t have to pay anything out of pocket, CMS confirms

Medicare beneficiaries will owe nothing out of pocket for receiving an authorized booster dose, and the same applies to almost all Medicaid beneficiaries and most commercial health plan members.

Nick Hut September 26, 2021

AMA releases 2022 CPT code set with new options that apply to COVID-19 vaccination, digital care services and more

The new set features more than 400 CPT code changes from 2021.

Nick Hut September 10, 2021

COVID-19 vaccination of staff now a condition of participation in Medicare and Medicaid, CMS announces

In a major expansion of COVID-19 vaccine requirements, the Biden administration announced Sept. 9 that all staff working at Medicare- and Medicaid-certified facilities must receive the vaccine.

Nick Hut September 9, 2021

Report by Medicare trustees describes a daunting payment picture for healthcare providers

The Medicare Hospital Insurance Trust Fund is on course to run out of money by 2026, and that assessment wasn’t the only concerning part for hospitals in a new government report.

Nick Hut September 8, 2021
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