Reimbursement

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.

Erika Grotto December 19, 2022

A quick holiday week news update with Nick and Shawn

HFMA Senior Editor Nick Hut and HFMA Policy Director Shawn Stack dive into the latest healthcare finance headlines in this shortened episode for Thanksgiving Week.

Erika Grotto December 19, 2022

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.

HFMA December 16, 2022

FY 2023 Inpatient Psychiatric Facilities Prospective Payment System Final Rule Summary

HFMA presents a detailed summary of the fiscal year (FY ) 2023 Inpatient Psychiatric Facilities (IPF) Prospective Payment System final rule describing updates to IPF rates and payment adjustments and the IPF Quality Reporting Program for FY 2023.

HFMA December 16, 2022

CY 2023 Physician Fee Schedule Final Rule Summary Part III – Quality Payment Program Updates

HFMA presents Part III of three detailed summaries of the final rule relating to the Medicare physician fee schedule for CY 2023 and other revisions to Medicare Part B policies.

HFMA December 16, 2022

The hospital labor picture could be improving, but a full financial recovery isn’t imminent

The financial and operational stress that has hampered hospitals may be easing in some ways, but probably not enough to qualify as a holiday gift for a beleaguered industry. Recent reports from credit-rating agencies have presented a mixed outlook. For example, Fitch Ratings released an analysis in December showing “incremental signs of improvement” in the staffing situation…

Nick Hut December 15, 2022

Healthcare News of Note: Advocate Aurora Health and Atrium Health megamerger complete

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Atrium and Advocate Health close merger deal, CMS details expectations of hospitals in memo addressing workplace violence, and CMS plans to recoup $650 million in overpayments to Medicare Advantage plans.

Deborah Filipek December 12, 2022

New federal rule aims to eventually ease prior authorization processes

CMS is seeking to improve the prior authorization process in government programs such as Medicare Advantage (MA) and Medicaid, although the core provisions would not begin until 2026. The agency this week updated a Trump administration proposed rule with new proposals to “improve patient and provider access to health information and streamline processes related to prior authorization…

Nick Hut December 9, 2022

CY 2023 Physician Fee Schedule Final Rule Summary Part II – Medicare Shared Savings Program Requirements

HFMA presents Part II of three detailed summaries of the final rule relating to the Medicare physician fee schedule for CY 2023 and other revisions to Medicare Part B policies. Part II covers the Medicare Shared Savings Program Requirements.

HFMA December 8, 2022

Reimbursement changes for 340B drugs reverberate in Medicare’s 2023 outpatient payment final rule

The Medicare payment rate for hospital outpatient services will increase significantly in 2023, but the net gain for the sector will be less than is apparent at first glance. Payment rates for hospital outpatient care and ambulatory surgical centers technically will increase by 3.8% over 2022 for facilities that meet quality-reporting requirements, CMS said in…

Nick Hut December 7, 2022
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