Legal and Regulatory Compliance

HHS: Insurers won’t be penalized if they don’t update their No Surprises Act qualifying payment amounts as required

Providers may not immediately benefit from a favorable court ruling that affects the methodology for determining the qualifying payment amount (QPA) under the No Surprises Act. The U.S. Department of Health and Human Services (HHS) issued guidance Oct. 6 that says the Biden administration will not enforce the court decision until at least May 1.…

Nick Hut October 9, 2023

PFC USA’s partnership approach ensures healthcare clients tackle regulatory and patient satisfaction issues

Review some tips from a company with 6.5 years of hands-on experience in helping its healthcare clients handle concerns in healthcare such as workforce shortages and a volatile regulatory environment.

HFMA September 29, 2023

Money received through the Provider Relief Fund could be at risk as audits ramp up

Recipients of Provider Relief Fund (PRF) distributions and COVID-19 Uninsured Program payments should be girding themselves for audits, legal experts say. The programs represent “a two-front audit fight that providers are facing and will face in the coming years,” Brian Lee, partner with Alston & Bird, said during an Aug. 24 webinar hosted by the…

Nick Hut September 1, 2023

The evolution of telehealth and the potential for sustainability

The surge in use of telehealth services seen during the pandemic has slowed, but telehealth remains a key modality amid policy changes that will help set the course for the future of virtual care. “There’s no alternative,” said Kyle Zebley, senior vice president for public policy with the American Telemedicine Association (ATA) and executive director…

Elizabeth Barker August 30, 2023

Key questions for providers after more than 2 years of the price transparency rule

Evidence amassed from over two years of experience with compliance reinforces why providers need to focus on chargemaster prices and self-pay discount policies — and how they can benefit from analyzing trends in consumers’ price searches.

Fred Stodolak August 25, 2023

Data indicate hospital operational logjams haven’t ceased after the public health emergency (updated)

Note: The fourth section of this article has been updated with news of proposed mandatory staffing ratios for long-term care facilities. Some of the problems that strained hospital operations during the peak of the COVID-19 pandemic have eased, but not enough to mark a true industrywide recovery, a recently released report suggests. Notably, the process…

Nick Hut August 24, 2023

Congress puts the community benefit standard for nonprofit hospitals under the microscope

The criteria that establish hospitals’ tax-exempt status are coming under closer scrutiny, with a bipartisan quartet of senators asking the IRS to ramp up its oversight of compliance with the community benefit standard. Sens. Bill Cassidy, MD (R-La.), Charles Grassley (R-Iowa), Raphael Warnock (D-Ga.) and Elizabeth Warren (D-Mass.) sent an Aug. 7 letter to the…

Nick Hut August 14, 2023

FTC and HHS’s Office for Civil Rights put healthcare stakeholders on notice about the use of tracking technology

Federal regulators plan to more rigorously monitor whether tracking technologies on provider websites are impermissibly disclosing consumers’ protected health information (PHI) to third parties in violation of HIPAA. The Federal Trade Commission (FTC) and the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services last month sent a letter to…

Nick Hut August 10, 2023

Cyberattack leaves hospitals scrambling in several states

A recent attack was the latest to illustrate the potential of cybercriminals to cause havoc across an interstate health system. The Los Angeles-based Prospect Medical Holdings system incurred a ransomware attack Aug. 3 that temporarily required some patients to be diverted from emergency departments and relegated hospitals to using paper records and incorporating other downtime…

Nick Hut August 7, 2023

The No Surprises Act arbitration portal is temporarily closed for business after providers’ latest legal victory (updated)

Note: See the bottom of this article for the latest updates. The U.S. Departments of Health and Human Services (HHS), Labor and Treasury on Friday temporarily shut down the system for settling disputes over out-of-network payment amounts under the No Surprises Act. A day earlier, a federal judge gave the Texas Medical Association (TMA) the…

Nick Hut August 4, 2023
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