Prior authorization in Medicare Advantage remains in the policy spotlight as 2024 regulations take effect
Healthcare policymakers and stakeholders continue to mull the need for guardrails to ensure optimal customer service among Medicare Advantage (MA) health plans. The American Hospital Association wrote a Nov. 20 letter to CMS stating that MA plans are looking to skirt policies designed to ensure straightforward coverage of essential healthcare services. These policies, finalized earlier…
Proposed rule sets Medicare penalties for providers that commit information-blocking infractions
Hospitals and other healthcare providers would face penalties for knowingly engaging in information blocking, with the sanctions affecting their Medicare reimbursement, according to a proposed rule from the U.S. Department of Health and Human Services (HHS) and CMS. Published at the beginning of November, the rule implements some terms of the 21st Century Cures Act,…
Leveraging investments to strengthen resilience: Key insights
The approach health systems take to balance sheet and treasury management varies significantly. One company's managing director dives into how organizations can take a balanced-scorecard method to investments using a tier system.
FTC and HHS’s Office for Civil Rights put healthcare stakeholders on notice about the use of tracking technology
Federal regulators plan to more rigorously monitor whether tracking technologies on provider websites are impermissibly disclosing consumers’ protected health information (PHI) to third parties in violation of HIPAA. The Federal Trade Commission (FTC) and the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services last month sent a letter to…
Creative solutions to tackling top challenges in healthcare: 3 key insights
In this roundtable, several healthcare leaders shared lessons they learned navigating through major challenges due to COVID-19 including data security concerns, high rates of burnout and workforce shortages.
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…
Conserving capital expenses through clinical asset reallocation
Michelle Brandt is vice president of physician, ambulatory contracting & credentialing at MedStar Health in Columbia, Maryland About TRIMEDX As an industry-leading, independent clinical asset management company, TRIMEDX helps healthcare providers transform their clinical assets into strategic tools, driving reductions in operational expenses, optimizing clinical asset capital spend, maximizing resources for patient care, and delivering improved safety & protection. This published piece is provided solely for informational purposes. HFMA does not endorse the published material or warrant or guarantee its accuracy. The statements and opinions by participants are those of the participants and not those of HFMA. References to commercial manufacturers, vendors, products, or services that may appear do not constitute endorsements by HFMA.
Revenue cycle technology budgets rise to meet need for automation, AI and robotics, says new survey
See five areas where there is room for additional automation according to respondents in a recent survey. Also read about using AI in the revenue cycle and the benefits it brings hospitals and healthcare systems such as dealing with staffing challenges, dwindling margins and increased denial rates.
Expanded information-blocking rules under the 21st Century Cures Act are here
Hospitals and health systems are among the healthcare industry stakeholders that will be impacted when expanded rules on information blocking take effect Oct. 6.
Revecore helps hospitals increase revenue with technology-driven underpayment review and recovery solutions
Read about one company's singular focus with its underpayment review and recovery solutions is to stop the leakage and increase revenue. The company’s solution is built on unique, customized technology to collect dollars that would have otherwise gone unrecovered.