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.
Big delays could be in store for early No Surprises Act arbitration cases
The portal for payment arbitration cases taking place under the No Surprises Act is open for business but could be facing a backlog of cases.
IPPS FY23 proposed rule: Tweaks are in store for Medicare’s quality-reporting and pay-for-performance programs
Temporary modifications to two pay-for-performance programs would ensure hospitals don’t face penalties amid the COVID-19 pandemic.
FY 2023 Inpatient Prospective Payment System/LTCH Proposed Rule Summary
HFMA presents a detailed summary of the proposed rule updating policies and payment rates to inpatient prospective payment system hospitals and long-term care hospitals.
Finding solutions to better manage payment process workflows
In this roundtable, revenue cycle leaders share their challenges, how they have enhanced payment processes through automation, and how they have identified opportunities for improvement.
OIG calls out issues with denials of payment and services in Medicare Advantage
Medicare Advantage processes related to prior authorization hamper beneficiaries’ access to medically necessary care, according to a new report from the HHS Office of Inspector General.
Tentative deal to provide pandemic funding won’t replenish the COVID-19 Uninsured Program
A bipartisan Senate bill would pay for additional vaccines and therapeutics but wouldn’t restore funding to a program that reimburses providers for furnishing COVID-19-related services to the uninsured.
News Briefs: Biden administration will apply closer scrutiny to healthcare billing practices
A monthly roundup of top news for healthcare finance professionals.
IPPS FY23 proposed rule: CMS seeks to bolster maternal health through a new public-facing hospital designation
Hospitals could attain the “Birthing Friendly” designation by attesting to having implemented best practices in maternal health.
Cost Effectiveness of Health Report, April 2022
The April 2022 edition of HFMA’s Cost Effectiveness of Health Report includes a preview the May issue of hfm, which focuses on telehealth, a key tool for promoting value-based care CEoH. Another article explores ways to promote health equity in revenue cycle processes, and a case study describes how one health system embarked on an initiative to achieve greater diversity among its revenue cycle staff.