News

Massive federal spending bill alleviates reimbursement concerns for hospitals, but less so for physicians

Healthcare provider advocates applauded the inclusion of key reimbursement relief measures and other policies in a proposed federal spending bill for FY23, although physician groups expressed concern about the outlook for their constituents. With a divided Congress looking to muster the votes to pass the legislation before a self-imposed deadline of week’s end, the bill includes many…

Nick Hut December 20, 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

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

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

HHS says the co-provider requirement for good-faith estimates is being tabled indefinitely

The U.S. Department of Health and Human Services has given hospitals and other healthcare providers a break on enforcement of a looming requirement for co-providers to be included on good-faith estimates (GFEs) furnished to uninsured patients.  HHS announced in an updated FAQ that it will continue to exercise “enforcement discretion” instead of potentially penalizing providers starting Jan.…

Nick Hut December 5, 2022

News Briefs: TMA returns to court over concerns about the No Surprises Act’s arbitration process

The Texas Medical Association has gone to court for a second time in less than a year over the independent dispute resolution process that’s part of the No Surprises Act.

Nick Hut November 18, 2022

Final regulations for rural emergency hospitals set the stage for first year of eligibility

REHs will be reimbursed for providing emergency care and outpatient services and must abide by terms and conditions that include limiting average length of stay to 24 hours.

Nick Hut November 18, 2022

Changes to reimbursement for 340B drugs reverberate in the 2023 final rule for Medicare outpatient payments

The Medicare payment rate for hospital outpatient services will increase significantly in 2023, but the net gain will be quite a bit less than is apparent at first glance.

Nick Hut November 2, 2022

When it comes to healthcare price transparency regulations, questions abound

A new era for healthcare price transparency has been underway for almost two years, but the potential impact remains murky. Price transparency requirements for hospitals were drafted by CMS during the Trump administration and went into effect Jan. 1, 2021. A companion rule for health plans was set to begin a year later, but the…

Nick Hut November 1, 2022

Reeling hospital industry shouldn’t anticipate a turnaround anytime soon

Amid persistent financial and operational turbulence for hospitals, it appears unrealistic to expect significant improvement in the near future.

Nick Hut November 1, 2022
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