CMS Tweaks BPCI-A Time Frames
July 16—Some key timing parameters of the next large Medicare alternative payment model were changed in recent weeks.
Colorado Healthcare System Increases Price Transparency for Self-Pay Patients
SCL Health shows self-pay prices in two ways—an average for a specific service and the range of prices charged in the past year. This helps set realistic expectations when prices are above average based on varying factors.
Self-Pay Transparency in Colorado: What the Law Says
Colorado’s Transparency in Direct Pay Health Care Prices Act requires health facilities to publish online the self-pay prices of their 50 most-used DRG codes and the 25 most-used CPT codes.
Your To-Do List When Health Plan Contracts Change
Six steps can help revenue cycle leaders manage health plan changes effectively.
Exemptions to Anthem’s ED Policy
Anthem will not deny an ED claim based on the prudent layperson standard if certain conditions apply.
Congress Pushes 340B Bills to Cut Eligibility, Increase Reporting
July 11—Members of Congress this week pushed emerging legislation to restrict the ability of hospitals and other providers to qualify for the 340B discount drug program and to increase their reporting requirements.
MA Gets Better Outcomes Despite Sicker Enrollees: Study
July 10—Contrary to general belief, Medicare Advantage (MA) plan enrollees are initially sicker than those in fee-for-service (FFS) Medicare, according to new research. And once enrolled, MA beneficiaries get better care at a lower cost.
Azar Promises Drugmaker Penalty Rule Coming
July 9—A five-times-delayed rule that would stiffen drugmaker penalties—among other provisions—will be implemented, the Trump administration’s healthcare policy leader told providers on Monday.
Transparency, Interoperability, DSH Changes Lead Hospital IPPS Concerns
July 6—Hospital advocates recently raised a range of concerns about proposed Medicare payment policy changes, including transparency and interoperability requirements and a new way to calculate uncompensated care payments.
Pilot to Offer APM Bonuses to Physicians in Medicare Advantage
July 3—Medicare plans to launch a pilot—as soon as this year—to allow physicians paid through Medicare Advantage value-based arrangements to qualify for the same bonuses as those working in advanced alternative payment models.