News

Healthcare Blame Game: Patient Rights Advocate claims its report gets ‘independent review and validation’ – but does it?

Headline: The Sixth Annual Hospital Price Transparency Compliance ReportSource: Patient Rights AdvocatePublished: February 2024 PatientRightsAdvocate.org recently issued its sixth report scoring hospital compliance with federal price transparency regulations, and for the sixth time, its assessment conflicts with CMS’s assessment. I want to focus on a nugget we picked up on in the methodology section of the latest report,…

Brad Dennison March 14, 2024

Responses to a new RFI will help guide regulations addressing consolidation and private equity in healthcare

The Biden administration is ramping up its assessment of how to regulate consolidation and private equity (PE) acquisitions in healthcare, issuing a request for information (RFI) from stakeholders. There is a deadline of May 6 to submit comments on the RFI, which was distributed by HHS, the Department of Justice (DOJ) and the Federal Trade…

Nick Hut March 13, 2024

Healthcare Financial Management Association calls Patient Rights Advocate’s latest price transparency compliance report ‘irresponsible’

CHICAGO (March 7, 2024) – Long an advocate for consumerism and price transparency in healthcare, the Healthcare Financial Management Association (HFMA) today called the latest report from Patient Rights Advocate (PRA) “irresponsible” and “incorrect.” HFMA has maintained that to be effective, price transparency must offer clear information that is readily accessible to patients to enable them to…

HFMA March 6, 2024

Federal funding legislation would address Medicaid DSH cuts, physician payments and more

March 8 update The Senate passed the appropriations bill by a 75-22 vote, getting it to the White House for President Joe Biden to sign hours before funding for some federal departments would have expired and a big cut to Medicaid disproportionate share hospital payments would have begun. Attention now turns to HHS and other…

Nick Hut March 6, 2024

New rule on Medicaid DSH payments will impose stricter limits on many hospitals

Numerous hospitals that receive Medicaid disproportionate share hospital (DSH) payments face a tighter cap on their payment amounts after the Feb. 23 publication of a CMS final rule. The regulations were spawned by 2020 year-end legislation that made changes to the DSH hospital-specific limit (HSL), including with respect to how third-party payments factor into the…

Nick Hut February 23, 2024

New data shows providers continuing to win most No Surprises Act independent dispute resolution cases

Providers won a large majority of disputes initiated during the first half of 2023 through the No Surprises Act’s arbitration portal for adjudicating out-of-network payments, according to newly published data. HHS and the U.S. Departments of Labor and Treasury released public-use files (available to download here under “2023 Reporting Year”) showing the outcome of every…

Nick Hut February 21, 2024

Site-neutral payment has backing in healthcare policy circles, but its efficacy as a cost restraint is unclear

The concept of site-neutral payment continues to receive support from members of Congress and healthcare policy analysts, as demonstrated during a recent hearing. The Jan. 31 hearing of the House Energy and Commerce Committee’s Health Subcommittee was intended, in part, to promote pending legislation that would strengthen price transparency and implement other policies designed to…

Nick Hut February 15, 2024

Hospitals reached steadier ground financially as they moved into 2024

Hospitals came into 2024 with some financial momentum, even as expenses continued to rise and pivotal decisions loomed. The year-to-date median hospital operating margin reached 2.3% in December, the high mark for 2023 and the 10th consecutive month in which margins were positive, according to monthly data from Syntellis Performance Solutions, part of Strata Decision…

Nick Hut February 12, 2024

CMS’s 2025 advance rate notice for Medicare Advantage brings potential concern for providers

Medicare Advantage (MA) health plans are projected to reap a 3.7% revenue increase in 2025, but provider payments could be affected by a decrease in plan benchmarks, per data shared in CMS’s annual advance notice. If finalized, the estimated 0.16% average reduction in base payments to plans could have consequences for care delivery, one provider…

Nick Hut February 7, 2024

Hospitals say Supreme Court should hear a case that affects disproportionate share hospital payments

Hospital advocacy groups hope the Supreme Court will review a lower-court ruling that has adverse implications for Medicare disproportionate share hospital (DSH) payments. Six groups on Feb. 2 submitted an amicus brief to the Supreme Court regarding an appeals court’s 2023 decision backing HHS’s interpretation of the DSH payment formula. The department long has said…

Nick Hut February 5, 2024
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