As providers seek resolution of continuing Change Healthcare issues, UnitedHealth Group reports strong financials
The aftermath of the Change Healthcare cyberattack affected the second-quarter financials of parent company UnitedHealth Group (UHG), but not to the point of hindering the company’s continued “diversified and durable growth,” CEO Andrew Witty said during a recent investor call. Q2 revenues increased by 6% year-over-year, while profits dropped by 5.5% amid costs stemming from…
Supreme Court ruling on Chevron makes regulations in healthcare (and other industries) more vulnerable to legal challenges
The U.S. Supreme Court issued a decision Friday that has dramatic implications for the regulatory infrastructure in healthcare, among many other industries. Since it was established in a 1984 case, Chevron deference has served as guidance to courts that regulatory authorities such as CMS and dozens of others across the federal government have license to…
HHS issues regulations to strengthen anti-discriminatory protections in healthcare (updated)
July 3 update A judge with the Southern District of Mississippi federal court granted an injunction preventing the Biden administration from enforcing regulations expanding anti-discrimination protections in the Affordable Care Act (ACA). Issued two days before the new rule was to take effect, the order applies to the provisions concerning gender identity. The move came…
Seeking to improve healthcare for Medicaid beneficiaries, CMS issues a flurry of regulations
CMS over the last month published a trio of final rules intended to make the Medicaid program work better for beneficiaries, with implications for healthcare providers. The three rules address eligibility and enrollment, access and Medicaid managed care. Streamlining eligibility and enrollment The first rule addresses administrative barriers in an effort to simplify enrollment processes…
The Medicaid unwinding continues to pose issues one year in, but healthcare coverage appears stable
The unwinding of Medicaid continuous-enrollment requirements reached the one-year mark this month amid mixed measures of the effect on overall coverage. In one sense, the impact has exceeded all projections. Since states could begin disenrolling Medicaid beneficiaries on April 1, 2023, coverage for more than 19.6 million beneficiaries had been terminated as of April 4,…
BESLER provides thorough Transfer DRG revenue recovery services
Hospitals require clear and simple paths through the challenges posed by changing regulations so they can spend more time and dollars focusing on enhancing patient care.
Highlights of the Administration’s FY 2025 Budget
HFMA presents a summary highlighting healthcare-related proposals included in the President’s Budget for fiscal year 2025, based on materials released by the Biden Administration on March 11, 2024.
Medicaid DSH Third-Party Payer Final Rule Summary
HFMA presents a detailed summary of the final rule issued by CMS addressing legislative changes to the hospital- specific limit on Medicaid disproportionate share hospital payments that took effect on October 1, 2021, as a result of the Consolidated Appropriations Act 2021.
Federal funding legislation would address Medicaid DSH cuts, physician payments and more
March 8 update The Senate passed the appropriations bill by a 75-22 vote, getting it to the White House for President Joe Biden to sign hours before funding for some federal departments would have expired and a big cut to Medicaid disproportionate share hospital payments would have begun. Attention now turns to HHS and other…
New rule on Medicaid DSH payments will impose stricter limits on many hospitals
Numerous hospitals that receive Medicaid disproportionate share hospital (DSH) payments face a tighter cap on their payment amounts after the Feb. 23 publication of a CMS final rule. The regulations were spawned by 2020 year-end legislation that made changes to the DSH hospital-specific limit (HSL), including with respect to how third-party payments factor into the…