Remedies for 340B underpayments remain up in the air after court declines to provide guidance
A federal court is allowing HHS to decide on remedies covering Medicare underpayments to hospitals for 340B drugs.
For the No Surprises Act arbitration process, 2023 brings a steep fee hike and continuing litigation
The No Surprises Act’s independent dispute resolution (IDR) process is about to become more expensive for healthcare stakeholders. In 2023, the nonrefundable administrative fee due from each party involved in any payment dispute that goes to arbitration will increase from $50 to $350, according to a Dec. 23 memo from CMS’s Center for Consumer Information and Insurance…
Massive federal spending bill alleviates reimbursement concerns for hospitals, but less so for physicians
Healthcare provider advocates applauded the inclusion of key reimbursement relief measures and other policies in a proposed federal spending bill for FY23, although physician groups expressed concern about the outlook for their constituents. With a divided Congress looking to muster the votes to pass the legislation before a self-imposed deadline of week’s end, the bill includes many…
HHS says the co-provider requirement for good-faith estimates is being tabled indefinitely
The U.S. Department of Health and Human Services has given hospitals and other healthcare providers a break on enforcement of a looming requirement for co-providers to be included on good-faith estimates (GFEs) furnished to uninsured patients. HHS announced in an updated FAQ that it will continue to exercise “enforcement discretion” instead of potentially penalizing providers starting Jan.…
Final regulations for rural emergency hospitals set the stage for first year of eligibility
REHs will be reimbursed for providing emergency care and outpatient services and must abide by terms and conditions that include limiting average length of stay to 24 hours.
Changes to reimbursement for 340B drugs reverberate in the 2023 final rule for Medicare outpatient payments
The Medicare payment rate for hospital outpatient services will increase significantly in 2023, but the net gain will be quite a bit less than is apparent at first glance.
What healthcare system leaders say about the value-based care journey
In this roundtable, executives for health plans and health systems share challenges in value-based care and the significance of moving away from fee-for-service toward value-based-care.
Payment Reimbursement and Managed Care
News Briefs: Hospital labor costs rose by almost 40% between 2019 and early 2022
As published in hfm magazine, a monthly roundup of top news for healthcare finance professionals.
Medicaid expansion doesn’t appear to bolster finances or operations at critical access hospitals, study finds
Changes in operating margin, staffing ratios and quality metrics didn’t hinge on whether a critical access hospital was in a state that had expanded Medicaid.