Legal and Regulatory Compliance

News Briefs: Healthcare industry disrupter CVS Health to shell out billions to buy Oak Street Health

A month after stating it hoped to gain a presence in primary care, CVS Health accomplished that goal with a massive deal that could fortify its efforts to advance value-based payment in healthcare. The proposed $10.6 billion acquisition of Oak Street Health, a provider of senior-focused primary care, adds to a portfolio of assets that…

Nick Hut February 28, 2023

Hospital price transparency update: Regulatory enforcement soon could become stricter, CMS leaders say

Although nothing is official, CMS leaders indicate enforcement of hospital price transparency regulations is set to become more stringent. For an article published in Health Affairs, the Center for Medicare’s Meena Seshamani, MD, PhD, director, and Douglas Jacobs, MD, chief transformation officer, touted progress that has been made since the rules took effect Jan. 1,…

Nick Hut February 24, 2023

Healthcare News of Note:  7 hospitals earn a Press Ganey award for outstanding nursing quality

Seven hospitals were recognized for elevating nursing excellence and improving patient outcomes with Press Ganey’s National Database of Nursing Quality Indicators Award for Outstanding Nursing Quality. Only 48% of Americans rank the quality of U.S. healthcare as excellent or good, according to results of a Gallup Health and Healthcare survey. Nearly half of Americans are…

Deborah Filipek February 20, 2023

DOJ withdraws guidance that bolstered antitrust safe harbors for GPOs, cost benchmarking and more

Potentially leading to stricter enforcement of antitrust policy in healthcare, the U.S. Department of Justice has withdrawn guidance that essentially promoted certain arrangements in the industry. The Feb. 3 announcement from DOJ’s Antitrust Division amounts to a cancellation of so-called “safety zones” that were established in three sets of nonbinding guidance issued between 1993 and…

Nick Hut February 20, 2023

Honor Roll: HFMA awards certifications to 2,746 members between September and December 2022

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 & Finance (CSAF), Certified Specialist Business Intelligence (CSBI), Certified Specialist Physician Practice…

Deborah Filipek February 7, 2023

OIG describes how hospitals can use NPs to treat patients without violating the Anti-Kickback Statute

An advisory opinion from the HHS Office of Inspector General (OIG) appears to give hospitals leeway to expand their use of nurse practitioners in specific situations without violating the Anti-Kickback Statute. OIG issued the opinion in December in response to an inquiry from an unnamed acute care hospital. The hospital was seeking clarification on whether…

Nick Hut February 1, 2023

News Briefs: 2023 brings a steep fee hike for No Surprises Act arbitration cases

The No Surprises Act’s independent dispute resolution (IDR) process has become more expensive for healthcare stakeholders. For the new year, the nonrefundable administrative fee due from each party involved in any payment dispute that goes to arbitration increased from $50 to $350, according to a Dec. 23 memo from CMS’s Center for Consumer Information and…

Nick Hut January 27, 2023

During a potentially tumultuous Congress, healthcare stakeholders should communicate their policy priorities

With the 118th Congress bringing the potential for policy upheaval, one of the best things healthcare stakeholders can do is make themselves heard on Capitol Hill. The new Republican majority in the House of Representatives has signaled its intent to use the federal debt ceiling as leverage in budget negotiations. President Joe Biden and the…

Nick Hut January 24, 2023

Medicare contractors should more closely examine providers’ bad debt claims, HHS watchdog says

Medicare administrative contractors (MACs) soon could apply more scrutiny to providers’ reported bad debts if CMS implements recommendations from the HHS Office of Inspector General (OIG). OIG in December issued a report in which it examined bad-debt reimbursement claims on Medicare cost reports spanning 2016 through 2018 for 67 randomly selected providers (including 29 hospitals). In those…

Nick Hut January 3, 2023

Beyond the News: Nick and Shawn discuss No Surprises, disruptors and everything else that made healthcare industry headlines in 2022

HFMA Senior Editor Nick Hut and HFMA Policy Director Shawn Stack discuss the top stories of 2022 in this special year-end episode.

Erika Grotto December 27, 2022
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