Health Plan Payment and Reimbursement

New rule describes the penalty associated with regulations on surprise billing

A new rule from HHS sets forth the maximum penalty for violations of new patient-billing regulations that take effect Jan. 1, 2022.

By Nick Hut September 14, 2021

AMA releases 2022 CPT code set with new options that apply to COVID-19 vaccination, digital care services and more

The new set features more than 400 CPT code changes from 2021.

By Nick Hut September 10, 2021

Healthcare News of Note: Providers should continue forward movement on improving digital patient access, survey suggests

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Expectations for convenient access to care in the pandemic era, a look at ICU bed use across the U.S., and the cost of hospitalizations among unvaccinated adults.

By Deborah Filipek September 3, 2021

Most health plans have stopped waiving cost-sharing for COVID-19 treatments, report finds

Researchers with the Kaiser Family Foundation said more and more people likely will receive “significant medical bills” for COVID-19-related care.

By Nick Hut August 21, 2021

Research examines whether financial challenges facing hospitals with large Medicare populations lead indirectly to cost shifting

Harvard researchers found evidence to suggest that hospitals with large shares of Medicare patients are at greater risk of being acquired, which can skew the market structure and lead to higher commercial prices.

By Nick Hut August 17, 2021

May 18-22: Virtual summit on state of the healthcare ecosystem post-coronavirus is among a slew of online-only events in healthcare finance

A complete listing of healthcare finance-related hearings, conferences, webinars, public forums and deadlines for the week of May 18.

By Rich Daly August 17, 2021

FY22 rule for the Inpatient Prospective Payment System finalizes a payment increase and key policy updates

The base payment increase for hospital inpatient services in FY22 will be 2.5%, according to a final rule issued by CMS.

By Nick Hut August 3, 2021

A closer look at the new surprise billing regulations: How cost sharing will be calculated

The qualifying payment amount that establishes a patient's cost sharing for out-of-network care also is intended to factor into negotiations between providers and health plans regarding payment.

By Nick Hut July 15, 2021

Healthcare News of Note: Few consumers are using publicly posted negotiated prices to comparison shop for healthcare services

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Little use of price transparency information to comparison shop for healthcare services, the nursing shortage being felt throughout the U.S., and cash payers being charged more for the same services than patients with insurance.

By Deborah Filipek July 9, 2021

A closer look at the new surprise billing regulations: The impact on balance billing

New regulations on surprise billing will affect hospital billing processes starting in 2022.

By Nick Hut July 9, 2021
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