News

News Briefs: A new fee is set for using the No Surprises Act arbitration portal

Bringing out-of-network payment disputes to arbitration under the No Surprises Act in 2024 will be less expensive than previously proposed. In a final rule, the U.S. Departments of Health and Human Services, Labor and Treasury established the administrative fee for using the independent dispute resolution (IDR) portal at $115 per case, effective Jan. 22. That’s…

Nick Hut January 30, 2024

Biden administration announces effort to make healthcare more competitive and transparent

Providers and insurers should be on the lookout for the Biden administration to hand down regulations and guidance intended to promote competition in healthcare. The White House in December released a fact sheet stating its position that a lack of competition affects healthcare prices and accessibility for consumers. Drug costs have been a target of…

Nick Hut January 30, 2024

Employer-sponsored healthcare coverage would benefit from better access to data, Congress is told

Employers can stimulate efforts to improve the value of healthcare, but they need help in the form of better access to claims data and prices, according to testimony at a recent congressional hearing. With those tools in hand, employers can more easily forge provider partnerships that lower costs and raise healthcare quality, health benefit administrators…

Nick Hut January 26, 2024

Honor Roll: HFMA certifications were awarded to 1,877 members Oct. 1, 2023 – Dec. 31, 2023

HFMA offers eight certifications for members to validate their expertise and demonstrate their commitment to the profession. The HFMA certifications are as follows: Certified Healthcare Financial Professional (CHFP), Certified Revenue Cycle Representative (CRCR), Certified Revenue Cycle Representative (CRCR) – GCC, Certified Specialist Accounting and Finance (CSAF), Certified Specialist Business Intelligence (CSBI), Certified Specialist Physician Practice…

Deborah Filipek January 25, 2024

5 reasons to apply for a prestigious MAP Award for revenue cycle performance

For more than a decade, HFMA’s MAP Award for High Performance in Revenue Cycle has become the highest honor in the healthcare industry for revenue cycle excellence. If that’s not enough of a reason to apply for the chance at these accolades, here are five reasons why past winners apply year after year. 1. Bragging…

Greg Akroyd January 24, 2024

In Congress, it’s status quo for Medicaid DSH payments and the Medicare physician fee schedule

Yet another short-term federal funding measure from Congress included yet another brief extension of full funding for Medicaid disproportionate share hospital (DSH) payments. With funding for much of the federal government set to expire Jan. 19, Congress agreed on a continuing resolution that keeps all agencies fully operational until March. Medicaid DSH payments are guaranteed…

Nick Hut January 22, 2024

New regulations are projected to bring providers a measure of relief from prior authorization headaches

Hospitals and other healthcare providers hailed a newly published final rule designed to improve prior authorization and the electronic exchange of health information. The Interoperability and Prior Authorization rule sets requirements for Medicare Advantage (MA) health plans, state Medicaid and CHIP programs, and Medicaid managed care organizations, all of which starting in 2026 must send…

Nick Hut January 18, 2024

Medicare beneficiaries would have new options for appealing their hospital patient status under a proposed rule from CMS

A proposed rule from CMS would affect the appeals process for some patients whose status is reclassified from inpatient to outpatient observation during a hospital stay. After a 2020 court ruling that was upheld at the appellate level in 2022, the U.S. Department of Health and Human Services and CMS were obligated to create additional…

Nick Hut January 17, 2024

The state of U.S. primary care: How new ways of thinking can spur meaningful improvement

As healthcare stakeholders consider ways to fortify the nation’s primary care system, industry leaders recommend emphasizing several strategies and components — and not waiting to act. “We’re close to midnight in many respects in thinking about how to urgently preserve and expand primary care in America,” Susan Dentzer, president and CEO of America’s Physician Groups…

Nick Hut January 16, 2024

Recent updates and emerging best practices for ACOs in the Medicare Shared Savings Program

Going into the 12th year since it brought accountable care into the healthcare lexicon, the Medicare Shared Savings Program (MSSP) continues to evolve, with CMS making changes and participants fine-tuning best practices. Starting with 220 accountable care organizations (ACOs) in 2012-13, the MSSP grew to 561 in 2018. However, the number has been below 500…

Nick Hut January 9, 2024
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