During a potentially tumultuous Congress, healthcare stakeholders should communicate their policy priorities
With the 118th Congress bringing the potential for policy upheaval, one of the best things healthcare stakeholders can do is make themselves heard on Capitol Hill. The new Republican majority in the House of Representatives has signaled its intent to use the federal debt ceiling as leverage in budget negotiations. President Joe Biden and the…
Key points to know in recently proposed rules for Medicare Advantage and the ACA marketplaces
A proposed rule for health plans in Medicare Advantage has provisions designed to stem overreach in prior authorization processes.
Seeking to phase out Medicare DSH payments, MedPAC outlines potential changes to reimbursement for safety net providers
Revamped formulas for hospitals and physicians would be designed to better target payments to providers that treat larger shares of low-income Medicare beneficiaries.
Remedies for 340B underpayments remain up in the air after court declines to provide guidance
A federal court is allowing HHS to decide on remedies covering Medicare underpayments to hospitals for 340B drugs.
Labor costs and other concerns dampen the outlook for not-for-profit hospitals this year
Insights from a leading credit-rating agency illustrate the scope of the financial challenges facing not-for-profit hospitals in 2023.
Healthcare News of Note: What healthcare sector innovations are consumers most excited about?
Some 48% of healthcare consumers surveyed said improved insight into how much care would cost was the No. 1 item they were excited about when it came to innovation in healthcare. Employers can expect an increase of more than 20,000% in adolescent mental health telehealth costs, according to a study showing telehealth appointments cost an…
Medicare contractors should more closely examine providers’ bad debt claims, HHS watchdog says
Medicare administrative contractors (MACs) soon could apply more scrutiny to providers’ reported bad debts if CMS implements recommendations from the HHS Office of Inspector General (OIG). OIG in December issued a report in which it examined bad-debt reimbursement claims on Medicare cost reports spanning 2016 through 2018 for 67 randomly selected providers (including 29 hospitals). In those…
For the No Surprises Act arbitration process, 2023 brings a steep fee hike and continuing litigation
The No Surprises Act’s independent dispute resolution (IDR) process is about to become more expensive for healthcare stakeholders. In 2023, the nonrefundable administrative fee due from each party involved in any payment dispute that goes to arbitration will increase from $50 to $350, according to a Dec. 23 memo from CMS’s Center for Consumer Information and Insurance…
Beyond the News: Nick and Shawn discuss No Surprises, disruptors and everything else that made healthcare industry headlines in 2022
HFMA Senior Editor Nick Hut and HFMA Policy Director Shawn Stack discuss the top stories of 2022 in this special year-end episode.
Healthcare News of Note: More than 3,500 deaths in the US attributed to long COVID during a 30-month period
For a 30-month period beginning in January 2020, long COVID played a part in the deaths of 3,544 people, according to a report by the CDC’s National Center for Health Statistics. The Department of Justice has support from hospital advocates as it looks to appeal a court ruling that allowed UnitedHealth Group to acquire Change…