Nick Hut
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Nick Hut
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CMS finalizes changes to the price transparency penalty, inpatient-only list and more for 2022
Medicare policies affecting price transparency, the inpatient-only list and more will take effect Jan. 1 after CMS published its 2022 final rule for hospital outpatient departments and ambulatory surgical centers.
Additional requirements are needed to make healthcare price transparency worthwhile, report states
Updates to price transparency regulations should address compliance and formatting and incorporate new data elements.
Payment approaches to addressing health equity are seen in a new Medicare rule for kidney care
Updates to a Center for Medicare & Medicaid Innovation care model for end-stage renal disease include an equity-related bonus payment and associated changes to benchmarking.
The impact of COVID-19 further shows the need to modify federal pay-for-performance models, hospital advocate says
Quality measures derived during the COVID-19 pandemic are not an accurate gauge of hospital performance in federal programs such as Value-Based Purchasing.
The Provider Relief Fund distribution formula may have left some higher-need hospitals at a disadvantage, study finds
Critical access hospitals generally received lower allocations from a targeted distribution pool compared with hospitals that had a better asset mix.
The Medicare area wage index likely needs a revamp, MedPAC members say
Wage index adjustments leave some hospitals at a disadvantage and are costly for the Medicare program, according to policy advisers.
Hospitals and Congress propose improvements to prior authorization processes in Medicare Advantage
The American Hospital Association says pending regulations that would affect prior authorization should be expanded to include Medicare Advantage.
Research highlights ways to save more than $250 billion per year through healthcare administrative simplification
Savings can be generated at the organizational and healthcare industry levels through steps to reduce wasteful administrative processes, study authors wrote.
Accountable care models will be almost universal for Medicare and Medicaid beneficiaries by 2030, CMS leaders say
A forthcoming revamp of federal value-based payment models will include features designed to encourage provider participation, CMS and CMMI leaders said.
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.