Medicaid Payment and Reimbursement

Here comes the Medicaid unwinding: The healthcare industry braces for coverage disruptions

A potentially tumultuous period for revenue cycle teams in particular and the U.S. healthcare system in general begins April 1, with the phasing out of a three-year run of Medicaid continuous enrollment. The so-called Medicaid “unwinding” originally was connected to end of the COVID-19 public health emergency (PHE), which is scheduled for May 11. But…

Nick Hut March 15, 2023

Medicaid DSH Third-Party Payer Proposed Rule Summary

HFMA presents a detailed summary of the proposed rule that would address legislative changes to the hospital-specific limit on Medicaid DSH payments as a result of the Consolidated Appropriations Act, 2021.

HFMA March 9, 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

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…

Nick Hut December 20, 2022

Prior Authorization and Interoperability for Medicare Advantage, Medicaid, CHIP, and QHPs Proposed Rule Summary

HFMA presents a detailed summary of the proposed rule designed to improve the electronic exchange of health care data and streamline prior authorization processes, while continuing to encourage interoperability in the healthcare market.

HFMA December 16, 2022

Healthcare News of Note: UnitedHealth Group can proceed with Change Healthcare purchase after a favorable decision in an antitrust case

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: UnitedHealth Group cleared to acquire Change Healthcare, standard patient satisfaction surveys need to address DEI issues, and homebound older adults contribute to higher levels of Medicare spending.

Deborah Filipek September 26, 2022

Healthcare News of Note: Telehealth aids outcomes for Medicare beneficiaries with opioid-use disorder

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Medicare beneficiaries initiating new episodes of OUD-related care get benefits from telehealth use, changes to inventory management strategies are coming for many sectors, and HAIs hit community hospitals hardest during the pandemic.

Deborah Filipek September 12, 2022

Helping healthcare organizations proactively verify and search for missed insurance coverage

Review how one company helps healthcare organizations verify and search for missed insurance coverage throughout the patient lifecycle and stay on top of benefits coordination.

HFMA August 31, 2022

CMS looks to tweak Medicare conditions of participation for critical access hospitals

A recently issued proposed rule includes a few new conditions of participation for critical access hospitals.

Nick Hut July 7, 2022

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.

Nick Hut May 27, 2022
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