Costs loom amid evolving trans care policies
Hospitals urged CMS to withdraw proposed rules aimed at barring “sex-rejecting procedures” on children, while others warned of costs. Several hospital groups raised objections to two proposed rules from CMS that would: A violation of the CoPs can result in monetary sanctions, exclusion from Medicare and Medicaid and, potentially, False Claims Act violations, noted a…
Breaking down key 2026 regulations for hospitals and physicians
HFMA policy director Katie Gilfillan joins Nick Hut and Shawn Stack as they discuss the Medicare physician fee schedule for 2026. Also in this episode, Nick and Shawn analyze the hospital OPPS Medicare payment update for 2026.
Humata Health prepares providers for Medicare’s WISeR model launch
The CEO of one of the six vendors implementing Medicare’s new prior authorization (PA) program recently addressed provider concerns on its payment model, uncertainty of the approach of the AI used and challenges in submitting data. The six-state CMS Wasteful and Inappropriate Service Reduction (WISeR) model, which launches Jan. 1, will require either PA or…
Hospitals urge ways to cut $1 trillion administrative cost
The American Hospital Association has submitted 100 regulatory changes to the Trump administration to reduce the estimated $1 trillion annual cost of health administrative requirements, including deregulating quality measures, billing and payment, and telehealth.