Ask the Experts: Non-Contracted Insurer Payment Rates
How can providers respond when non-contracted insurers offer payments limited to some share of Medicare payments for a given service?
HFMA Comments on the CMS Discharge Planning Proposed Rule
HFMA comments on the CMS proposed rule on Medicare and Medicaid Programs: Revisions to Requirements for Discharge Planning for Hospitals, Critical Access Hospitals, and Home Health Agencies.
CY16 OPPS Final Rule Fact Sheet
This fact sheet highlights 2016 payment rate updates to outpatient hospitals and ambulatory surgical centers under the Medicare Outpatient Prospective Payment System (OPPS).
HFMA Comprehensive Care for Joint Replacement Final Rule Executive Summary
This Executive Summary provides the top 10 issues providers need to understand from the Comprehensive Care for Joint Replacement (CJR) final rule, published in the November 24, 2015, Federal Register.
HFMA’s Regulatory Sound Bites: An Overview of the Final 2016 Inpatient Prospective Payment System Rule
This presentation provides a summary of 2016 inpatient prospective payment system updates that affect inpatient acute care hospitals.
Executive Summary – CY 2016 OPPS Final Rule
This summary features the top 10 issues providers need to understand from the CY16 outpatient prospective payment system (OPPS) final rule, published in the November 13, 2015, Federal Register.
HFMA Legislative Update Bipartisan Budget Act of 2015
This legislative update provides answers to questions pertaining to Section 603 of the Bipartisan Budget Act of 2015 implementing (with limited exemptions) site neutral payments for new Provider-Based Hospital Outpatient Departments.
Utilization Review Reduces Inpatient Denials
Covenant Health’s utilization review strategies have helped the health system recoup the difference between inpatient and observation status payments.
Discharge Planning CMS Proposal
CMS has published a proposed rule to modernize discharge planning requirements to improve patient care, reduce complications, and avoid readmissions.
HFMA Comments on the HRSA 340B Drug Pricing Program Omnibus Guidance
The 340B program stretches resources for care to indigent and at-risk populations. Without this program, these individuals would find more difficulty in finding ready access to care and medications.