Legislation to enhance healthcare pricing and billing transparency takes a big step forward in the House
A slew of provisions on healthcare transparency took a step closer to becoming federal law as three House committees last week merged separate bills into a single draft. The resulting bill is just about set for consideration by the full House, where bipartisan support for the major provisions was apparent in the committee phase. The…
The future of healthcare transparency, with Nick Hut and Andrew Donahue
HFMA Senior Editor Nick Hut and HFMA Policy Director Andrew Donohue discuss legislative action that could affect transparency efforts in healthcare.
News Briefs: Hospitals foresee adverse impacts from the FY24 inpatient payment rule
The FY24 final rule for Medicare inpatient payments didn’t bring hospitals the type of rate update they had sought, and for some organizations, a bigger concern is changes to uncompensated care (UC) payments. The regulations, which take effect Oct. 1, establish a 3.1% increase in operating payment rates, on average, for hospitals that meet quality-reporting…
Leverage healthcare price transparency data to promote financial sustainability
Healthcare organizations are encouraged to review strategies and how to collaborate with payers, among other insights in this article, in order to grow healthcare consumer trust, engagement and retention.
In proposed regulations, CMS seeks to strengthen hospital price transparency requirements
Hospital price transparency regulations are undergoing changes heading into their fourth year as CMS seeks to step up enforcement while making compliance more straightforward. As part of the 2024 proposed rule for hospital outpatient payments, CMS is adding to the requirement for hospitals to maintain a machine-readable file of their charges for services. In addition,…
Annual Conference: How Mayo Clinic establishes the mindset and processes that foster innovation
Hospitals and health systems must adapt their practices using an innovator’s mindset to keep up with the change sweeping the industry, according to a presentation this week at HFMA’s Annual Conference. “Innovation, at this point in our industry’s landscape, is pretty critical,” said Praveen Mekala, enterprise division chair with Mayo Clinic, referring to the problems…
Annual Conference: Healthcare entrepreneur Alex Oshmyansky describes his efforts to disrupt drug pricing
Arguably no segment of the healthcare industry is more susceptible to disruption than the market for prescription drugs, as Alex Oshmyansky, MD, PhD, made clear Wednesday morning during the closing session of HFMA’s Annual Conference. Oshmyansky spoke about his personal efforts to disrupt the pharmaceutical market in his role as co-founder and CEO of Mark…
News Briefs: The expiration of the COVID-19 PHE brings an end to key provisions
The termination of the COVID-19 public health emergency (PHE) on May 11 meant providers lost many of the accommodations and regulatory flexibilities that were in place since Jan. 31, 2020. For example, Medicare’s 20% add-on payment for treating COVID-19 cases in the inpatient setting no longer is available. With reported cases and hospitalizations steadily trending…
Hospital price transparency updates include stricter enforcement, new fines and pending legislation
(Note: The last section of this article was updated May 24 where noted to reflect developments in Congress.) Enforcement of hospital price transparency regulations is becoming stricter, with CMS implementing new policies and recently fining two hospitals. Changes were anticipated after CMS leaders authored an article in February that reported 70% compliance in 2022, the…
5 issues that are keeping healthcare compliance professionals up at night
Rarely has the compliance landscape been more muddled or presented more of a challenge for healthcare organizations. “I’ve been a compliance officer for about 20 years now, and I’ve been in healthcare forever,” said Kirsten Wild, RN, a nurse by background who now owns a healthcare compliance consultancy. “But the volume and the pace of…