Tag: Article

In new final rule, CMS looks to claw back billions in overpayments to Medicare Advantage health plans

CMS has confirmed a new approach to its auditing of payments directed to Medicare Advantage health plans, but the agency says the regulatory burden on providers should not increase. A newly published final rule on risk adjustment data validation (RADV) establishes that CMS will use an extrapolation methodology to recoup overpayments to MA plans beginning…

Nick Hut February 3, 2023

OIG describes how hospitals can use NPs to treat patients without violating the Anti-Kickback Statute

An advisory opinion from the HHS Office of Inspector General (OIG) appears to give hospitals leeway to expand their use of nurse practitioners in specific situations without violating the Anti-Kickback Statute. OIG issued the opinion in December in response to an inquiry from an unnamed acute care hospital. The hospital was seeking clarification on whether…

Nick Hut February 1, 2023

Norton Healthcare commits time, money to improving health equity

In June 2020, Norton Healthcare, the largest health system in Louisville, announced five imperatives to address health inequities, four of them being:   Start a health equity institute   Improve diversity in its leadership ranks  Educate its staff to advocate for health policy issues  Invest more money to address health needs in underserved areas  The remaining item…

Lola Butcher January 30, 2023

Point-of-service collection goes better if the right strategies and tactics are employed. 

Improving point-of-service (POS) collection has long been a topic of discussions across healthcare organizations struggling to meet collection goals. But the global pandemic and its aftermath have intensified the need for more effective strategies to meet this challenge while keeping a patient-centered focus. Health systems need to adopt new strategies that will support a positive…

Stacie M. Johnson, MAEd, CRCR, CSBI January 30, 2023

Norton Healthcare and other health systems are making big moves to reduce health inequity

When Louisville police officers killed Breonna Taylor, a young Black woman not suspected of any crime, in her home in March 2020, the president and CEO of Norton Healthcare took it personally.  “As an employer of 18,000 people and a very prominent organization in our community, we needed to be the ones to step up…

Lola Butcher January 30, 2023

How healthcare providers can break down barriers to effective data governance

Promoting improved data governance in the hospital and health system sector has become a just cause of sorts for Randy Albert, who serves as vice president of finance – operations and analytics at Maine-based Northern Light Health and is a member of HFMA’s Northern New England Chapter. “This is a topic that I’m incredibly passionate…

Nick Hut January 27, 2023

News Briefs: 2023 brings a steep fee hike for No Surprises Act arbitration cases

The No Surprises Act’s independent dispute resolution (IDR) process has become more expensive for healthcare stakeholders. For the new year, the nonrefundable administrative fee due from each party involved in any payment dispute that goes to arbitration increased from $50 to $350, according to a Dec. 23 memo from CMS’s Center for Consumer Information and…

Nick Hut January 27, 2023

CVS Health pushes forward with efforts to reshape segments of the healthcare industry

About two decades after adding the first three MinuteClinics to its stores, in 2005, CVS Health continues to grow as one of the biggest disruptors in healthcare. The company has embarked on a series of strategic transactions that make it a major player across an increasingly large swath of the industry, as described this month…

Nick Hut January 27, 2023

Time to take a fresh look at affiliation options for physicians and health systems

As the healthcare marketplace continues to evolve, posing new challenges and creating new opportunities, so too will affiliation models continue evolve in ways that can best meet current and future needs of healthcare providers. In this environment, health systems and physician practices — both independent and employed — could benefit from taking a fresh look…

Matthew Bates January 27, 2023

During a potentially tumultuous Congress, healthcare stakeholders should communicate their policy priorities

With the 118th Congress bringing the potential for policy upheaval, one of the best things healthcare stakeholders can do is make themselves heard on Capitol Hill. The new Republican majority in the House of Representatives has signaled its intent to use the federal debt ceiling as leverage in budget negotiations. President Joe Biden and the…

Nick Hut January 24, 2023
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