Cost:

Free for HFMA Members
Buy HFMA Membership to Attend

Audience:

Hospitals and Other Providers
Business Partners
Physicians and Other Practitioners

Career level:

Experienced Professional
Early Careerist
Mid-Senior

Recommended for:

Physician Practice
Reimbursement
Revenue Cycle

Delivery Method:

Self Study

Advance Preparation:

None

Prerequisites:

None

Course Availability:

18 Months

News | Medicare Payment and Reimbursement
The CY21 OPPS proposed rule would eliminate the inpatient-only list of services over three years while increasing the number of ASC-eligible procedures, and also would increase 340B payment cuts and overhaul the hospital star-rating system.
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Blog | Medicare Payment and Reimbursement
HFMA's Chad Mulvany says the Most Favored Nation pricing executive order faces long odds of becoming an enforced policy because it faces significant opposition from three of the most influential lobbies in Washington, D.C.
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News | Medicare Payment and Reimbursement
An appeals court upheld $1.6 billion in annual Medicare payment cuts to 340B hospitals.
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Blog | Medicare Payment and Reimbursement
Recommendations from healthcare economists for savings to preserve Part A Trust Fund focus more on taxes and less on providers.
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Blog | Medicare Payment and Reimbursement
HFMA's Chad Mulvany explains why a small percentage point increase in the uninsured rate could significantly impact the UC DSH dollars available to safety net hospitals at a time when they are financially struggling due to COVID-19.
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Course | Overview | Medicare Payment and Reimbursement

Essentials of Medicare and Medicaid Managed Care

Course | Overview | Medicare Payment and Reimbursement

Essentials of Medicare and Medicaid Managed Care

Description

This course provides a brief history and overview of Medicare and Medicaid. It describes government organizations that regulate and administer this program. This course also discusses Medicare reimbursement. In addition, it highlights recent changes in the law affecting Medicare managed care contracting. This course also identifies the rights and responsibilities of Medicare enrollees. It also provides an overview of the Medicare Part D pharmacy benefit and points out some successes and failures of Medicaid managed care.

Estimated course completion time: 1 hour
After this program, you'll be able to..
  • Provide an overview of Medicare and its history
  • Recognize how the Centers for Medicare and Medicaid Services (CMS), the Federal Trade Commission (FTC), the Internal Revenue Service (IRS), the Office of the Inspector General (OIG), the Department of Justice (DOJ), the Securities and Exchange Commission (SEC), and the U.S. Public Health Service administer and regulate Medicare
  • Define the Inpatient Prospective Payment System
  • Recognize the Outpatient Medicare Prospective Payment System
  • Recognize how Medicare provides payment to physicians
  • Recognize relevant legislative changes affecting Medicare managed care
  • Recognize demonstration projects
  • Recognize examples of these projects
  • Identify key elements of ABNs
  • Identify the rights and responsibilities of Medicare enrollees
  • Recognize the features of Medicare Part D
  • Identify how healthcare providers are paid under Medicaid
  • Recognize successes and failures of Medicaid managed care

Related Courses | Medicare Payment and Reimbursement

On Demand Webinar | Overview | Coronavirus

Patient care in crisis: How to launch, code and bill telehealth services (Spring 2020 Virtual Conference On-demand)

Due to the coronavirus/COVID-19 crisis, physicians and health leaders are under tremendous pressure to meet the demands of patient care while stabilizing operational and financial health. This session will showcase a telehealth demonstration and discuss how providers can implement telehealth quickly and efficiently.


Original live session date: 4/9/2020

Course | Advanced | Payment Trends

Healthcare Finance: The Big Picture

Next to national defense, the healthcare industry in the United States is one of the largest sectors of the economy. Currently making up almost 20 percent of the nation's gross domestic product, health care in the U.S. will be a significant factor in the national economy for the foreseeable future.


Estimated course completion time: 1 hour and 30 minutes

On Demand Webinar | Update | Legal and Regulatory Compliance

2020 Final Rule changes to Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Centers (ASC)

The ambulatory surgery center (ASC) payment system continues to evolve with the proposed changes to the hospital payment system (OPPS) for calendar year 2020. Fnd out what changes are proposed for implementation on January 1, 2020 for ASCs and hospital outpatient services in the CY2020 final rule. Physician practice managers will want to keep a close watch on the ASC and OPPS developments as more services migrate from one setting to another. Prepare your organization now for the proposed changes.

Topics Include:

  • Latest update on CMS' pricing transparency initiatives
  • 2020 OPPS changes to drugs, biological, and radiopharmaceuticals
  • 2020 340B drug rules
  • 2020 changes to OPPS for cancer hospitals and partial hospitalization services
  • 2020 changes to OPPS packaging
  • 2020 methods to control outpatient volume increases related to clinic visits
  • 2020 changes for ASCs
  • 2020 changes to hospital outpatient and ASC quality requirements
  • Additional changes to other policy areas such as prior authorizations and laboratory date of service rules
Original Live Webinar Date: 12/17/19

On Demand Webinar | Overview | Financial Leadership

Proposed Changes to the Physician Self-Referral (Stark) Law to Promote Value-Based Payments

The Centers for Medicare and Medicaid Services (CMS) has proposed the most sweeping changes to the regulations that interpret the physician self-referral law (the "Stark Law") in over twenty years. This webinar will principally focus on how the newly-proposed regulations, if finalized, would afford hospitals, physician groups, clinics, and other care providers significant additional flexibility to compensate physicians for collaboration on value-based care arrangements involving commercial, Medicare, or other patient populations. It will also provide an overview of other helpful proposed changes affecting an even broader array of physician compensation arrangements.

Original live webinar date: 11/18/19