Shawn Stack
About the Author
Shawn Stack
Latest Work
How HFMA worked with members through the Change Healthcare cybersecurity breach
Change Healthcare, a healthcare technology company owned by UnitedHealth Group, disclosed on Feb. 21 that it had fallen victim to a cyberattack, causing disruptions to several of its systems and services. According to a statement released on its website on Feb. 22, around noon EST, UnitedHealth Group confirmed the incident, stating, “At this time, we…
Pharmacy transparency: a rising trend in the industry
After publishing my Nov. 29 blog, which delved into Cost Plus Drugs’ expansion into the specialty drug market, CVS Health revealed plans to streamline its pricing and sales approach for pharmaceuticals in retail pharmacies. This move by the pharmacy giant, which operates approximately 9,500 retail pharmacies, involves simplifying the reimbursement process for these pharmacies. The…
Cost Plus Drugs announces its expansion into specialty drugs
If you have ever attended one of my lectures over the past three years, it is very rare that I don’t at least mention Cost Plus Drugs and the impact they have made in the pharmaceutical sales industry. The latest news on Cost Plus Drug Company Just this week, Mark Cuban, the founder of Cost…
CMS’s 340B-acquired drug payment policy final rule is here
The 340B Drug Pricing Program final rule was published[DF1] [SS2] [SS3] in the Federal Register Nov. 8, 2023, after CMS released details of it (CMS-1793-F) on Nov. 2, 2023. The rule details the agency’s actions, and in some cases non-actions, to adjust Medicare payment rates for drugs acquired under the 340B program from calendar year 2018 through Sept.…
American providers remain in reimbursement limbo during IDR failure
HFMA and its member healthcare providers are growing more concerned over the extended delay of reimbursement from group health plans subject to the unresolved No Surprises Act IDR regulations and guidance. HFMA members continue to report that numerous health plans persist in determining very low rates for calculating the Quality Performance Assessment (QPA) they are…
Patient Rights Advocate continues to misinterpret price transparency data with latest report
Once again, Patient Rights Advocate (PRA) has issued a report that misrepresents compliance with CMS price transparency regulations. (Read my March blog about a previous PRA report here.) PRA’s most recent “Hospital Price Transparency Compliance Report,” published in July, examines websites of 2,000 U.S. hospitals. Its findings were that only 36% of those hospitals fully…
Navigating Medicare’s 2024 inpatient payment rule
On Aug. 1, 2023, CMS published its final rule for federal FY24 inpatient prospective payment system (IPPS). Undoubtedly, navigating such complexity in a healthcare rule can be quite challenging. The purpose of this blog post is to provide some much-needed clarity regarding the new rule, enabling healthcare finance leaders to direct their attention towards the…
Medicare’s proposed remedy for 340B-acquired drug underpayments: Addressing only half at best?
On July 7, 2023, CMS released a proposed rule, identified as CMS-1793-P, which outlines the agency’s intended actions to address the adjustment of Medicare payment rates for drugs acquired under the 340B Drug Pricing Program. This proposed rule pertains to the period spanning from calendar year 2018 through Sept. 27, 2022. The necessity for this remedy…
PatientRightsAdvocate.org misinterprets CMS rules in low estimate of hospital price transparency compliance
In February, PatientRightsAdvocate.org (PRA) published its Fourth Semi-Annual Hospital Price Transparency Report, which states that only 24.5% of hospitals are compliant with federal price transparency regulations. This is a vast contradiction of CMS’s own compliance findings, which show 70% overall compliance during the same timeframe, as published in a Health Affairs blog on Feb. 14.…
Shawn Stack: No Surprises Act is important move toward meaningful consumer transparency
The No Surprises Act, which became effective on Jan. 1 of 2022, will clearly benefit patients, .ut its larger impact is yet to be seen as the industry awaits the release of provisions targeting health plans and payers.