Managed Care

HFMA Comments on Federal Independent Dispute Resolution Operations, Proposed Rule

HFMA presents its comment letter on CMS’ Federal Independent Dispute Resolution Operations Proposed Rule.

HFMA December 6, 2023

HFMA Comments on Federal Independent Dispute Resolution Process Fees Proposed Rule

HFMA presents its comment letter on CMS’ Federal Independent Dispute Resolution Process Fees Proposed Rule.

HFMA October 26, 2023

Medicaid Drug Misclassification Proposed Rule Summary

The rule proposes to implement policies in the Medicaid Drug Rebate Program (MDRP) related to legislative requirements addressing drug misclassification, as well as drug pricing and product data misreporting by manufacturers.

HFMA June 20, 2023

Ensuring Access to Medicaid Services Proposed Rule Summary

On May 3, 2023, CMS published in the Federal Register a proposed rule entitled “Medicaid Program; Ensuring Access to Medicaid Services” (88 FR 27960-28089). The rule proposes policies that take a comprehensive approach to improving access to care, quality and health outcomes, and better addressing health equity issues in the Medicaid program across fee-for-service, managed care delivery…

HFMA June 5, 2023

How managed care contracting strategies promote operational resilience

Read this article for an in depth look on several strategic steps for healthcare leaders to take to benefit their organization's managed care contracting.

HFMA April 28, 2023

Highlights of the Administration’s FY 2024 Budget

HFMA presents a summary of healthcare-related proposals included in the President’s budget for fiscal year 2024, released by the Biden Administration on March 9, 2023.

HFMA March 21, 2023

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: Newest nurses now fill the greatest number of 12-hour shifts

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: New nurses fill the largest number of shifts, some heart failure patients find the cost of medications unaffordable, and inaccuracies in CMS data make it difficult to address healthcare disparities.

Deborah Filipek July 14, 2022

Healthcare News of Note: U.S. Surgeon General says the nation must stop health worker burnout

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: U.S. Surgeon General says healthcare worker burnout is a national issue that must be addressed, the Digital Health for Equitable Health Alliance was just launched, and a survey shows funding is needed for ACOs to provide more home-based services.

Deborah Filipek June 21, 2022

2023 regulations for Medicare Advantage and ACA marketplaces seek to enhance network adequacy standards

HHS and CMS recently released sets of 2023 regulations that affect provider network adequacy standards in Medicare Advantage and the Affordable Care Act insurance marketplaces.

Nick Hut May 9, 2022
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