Medicare Payment and Reimbursement

Survey data highlights shortcomings in private insurance coverage compared with Medicare

Indicators of coverage gaps were more likely to be seen among individuals with private insurance.

By Nick Hut June 2, 2021

USA Senior Care Network provides hospitals with incremental patient volume and increased revenue

One company’s senior director explains how hospitals or health systems can grow their market share without risk of bad debt when joining this company’s network.

By HFMA June 2, 2021

News briefs: In a win for hospitals, CMS removes a rate-reporting requirement from the Medicare FY22 IPPS

Recent healthcare finance and policy news included the release of the proposed rule for the FY22 Inpatient Prospective Payment System.

By Nick Hut June 1, 2021

Healthcare News of Note: Health systems’ new C-suite titles reflect today’s industry issues

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: New healthcare C-suite titles, tips from CMS on securing federal funds for certain Medicaid services and a Senate subcommittee hearing on the nation’s growing mental health crisis.

By Deborah Filipek May 21, 2021

As the Senate Finance Committee considers telehealth expansion, payment approaches are a key talking point

A congressional hearing featured testimony about why fee-for-service is not a viable way to fund a Medicare telehealth expansion.

By Nick Hut May 20, 2021

Looming changes to quality reporting in the Medicare Shared Savings Program draw strong pushback from healthcare providers

Healthcare provider organizations are petitioning the Biden administration to slow recently finalized quality-related changes to the Medicare Shared Savings Program.

By Nick Hut May 18, 2021

CMS increases the payment rate for administering authorized monoclonal antibody treatments to patients with COVID-19

CMS has provided a nearly 50% boost in payment to providers that administer monoclonal antibodies to beneficiaries with COVID-19.

By Nick Hut May 17, 2021

Proposed FY 2022 IPPS Rule: Hospital finance and revenue cycle teams, clinicians and payers are assessing the rule impacts and preparing their responses

HFMA’s Shawn Stack summarizes the Proposed FY 2022 IPPS Rule, and says health systems, payers and providers have until June 28 to provide CMS with input.

By Shawn Stack May 11, 2021

CMS is curtailing voluntary participation in the Comprehensive Care for Joint Replacement bundled payment model

Hospitals that participated in the Comprehensive Care for Joint Replacement model on a voluntary basis over the last three years will be excluded after Sept. 30.

By Nick Hut May 3, 2021

In a win for hospitals, CMS removes a rate-reporting requirement from the Medicare FY22 Inpatient Prospective Payment System

An FY22 requirement for hospitals to disclose privately negotiated MA rates on their Medicare cost reports has been rescinded in the proposed rule for the Inpatient Prospective Payment System.

By Nick Hut April 29, 2021
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