Medicaid Payment and Reimbursement

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…

By 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.

By 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.

By 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.

By 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.

By 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.

By 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.

By Nick Hut May 27, 2022

Tentative deal to provide pandemic funding won’t replenish the COVID-19 Uninsured Program

A bipartisan Senate bill would pay for additional vaccines and therapeutics but wouldn’t restore funding to a program that reimburses providers for furnishing COVID-19-related services to the uninsured.

By Nick Hut April 27, 2022

CMS leaders explain final plans to restrict Medicare coverage of new Alzheimer’s drug

CMS mostly finalized previously proposed criteria for coverage of Aduhelm, which has been promoted as the first drug to treat the underlying pathology of Alzheimer’s disease.

By Nick Hut April 16, 2022

Healthcare spending projections for the next decade reflect an expectation of steadying trends post-pandemic

CMS actuaries say the healthcare spending spike of 2020 will be tempered across sectors and payers in upcoming years.

By Nick Hut March 30, 2022
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