Senate hearing on Steward Health Care depicts consequences of hospital management decisions
After the CEO of Steward Health Care rebuffed a subpoena to appear Thursday at a Senate committee hearing, members and invited panelists used the occasion to bemoan the company’s hospital ownership record and the private equity healthcare model generally. Ralph de la Torre, MD, the CEO, spurned the summons to appear before the Senate HELP…
New federal rule means big changes in coverage of behavioral healthcare
Landmark regulations issued by the Biden administration are intended to establish coverage parity for behavioral healthcare services. A newly published final rule prohibits group health plans, along with health insurers offering group or individual insurance coverage, from restricting access to mental-health and substance-use disorder (SUD) benefits as compared with medical and surgical benefits. The rule,…
Medicare administrative contractor news includes a data breach and potential consolidation
Recent happenings involving Medicare administrative contractors (MACs) include a notice of a data breach and a request for feedback on possible consolidation. CMS sent out word that nearly 950,000 Medicare beneficiaries whose claims go through Wisconsin Physicians Service Insurance Corporation (WPS) are being informed that their protected health information or other personally identifiable information may…
HHS concedes defeat in litigation over providers’ use of tracking technologies on websites
The hospital lobby cemented its victory in litigation about online tracking tools after HHS canceled its planned appeal. In June, the American Hospital Association (AHA) and co-plaintiffs won a decision in a Texas federal court about 2022 guidance (revised and somewhat softened in 2024) instructing hospitals and other HIPAA-covered entities to avoid using online tracking…
Congress only has a few more months to ensure expansive telehealth access continues
The clock is ticking on efforts to maintain the telehealth flexibilities that have been in place since the start of the COVID-19 pandemic, with advocates hoping Congress will act before year’s end. Key waivers will conclude at the close of 2024 unless legislation is passed to extend them. Congress faced a similar scenario in 2022…
Harnessing automation in patient access for revenue optimization
Patient access is often treated like a stand-alone process instead of a vital part of the revenue cycle puzzle. The truth is that errors during this critical stage of the revenue cycle are often the cause of claim errors, delayed care and denials. In addition, as the first step of a patient encounter, the patient…
ONC issues proposed technical standards to improve health information sharing
Proposed regulations bring healthcare providers and patients a step closer to gaining access to key health information stored in payer databases. Provisions in a proposed rule published Aug. 5 by the Office of the National Coordinator for Health Information Technology (ONC) support a CMS final rule released in 2020 and another issued early this year,…
Johnson & Johnson looks to make a big change in how hospitals obtain 340B price discounts
A leading drug manufacturer opened a new chapter in the fight with hospitals over the 340B Drug Pricing Program, requiring the use of a rebate program to receive discounts. Following manufacturer efforts over the last several years to limit the discounts available to providers through contract pharmacies, Johnson & Johnson announced it would offer 340B…
A key election question: What will happen to the enhanced Affordable Care Act subsidies?
Earl Pomeroy knows from experience that the politics surrounding the Affordable Care Act (ACA) are dicey. As a Democratic member of the House Ways and Means Committee, Pomeroy helped pass the ACA during his ninth term representing North Dakota. After that, “I lost my job,” he recalled. Since his time in Congress ended with his…
How to re-engage hospitalists, rebuild care teams and improve LOS in the post-COVID environment
Healthcare teams are facing disrupted communication pathways and relationships due to the COVID-19 pandemic, leading to increased length of stay (LOS) and financial performance issues, but a back-to-basics approach with hospitalists leading care team rebuilding can help overcome these challenges.