Requirements Related to Surprise Billing; Part I Summary of Interim Final Rule with Comment
HFMA presents a detailed summary of the interim final rules with comment period that amend and add to existing regulations to implement provisions of the No Surprises Act enacted as part of the Consolidated Appropriations Act, 2021.
A closer look at the new surprise billing regulations: How cost sharing will be calculated
The qualifying payment amount that establishes a patient's cost sharing for out-of-network care also is intended to factor into negotiations between providers and health plans regarding payment.
Healthcare News of Note: Few consumers are using publicly posted negotiated prices to comparison shop for healthcare services
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Little use of price transparency information to comparison shop for healthcare services, the nursing shortage being felt throughout the U.S., and cash payers being charged more for the same services than patients with insurance.
Newer payment models should be part of holistic transformation efforts, CMS deputy administrator says
Healthcare industry stakeholders can expect a new approach to how federal payment models are formulated, as a newly released rule for Medicare coverage of kidney care illustrates.
A closer look at the new surprise billing regulations: The impact on balance billing
New regulations on surprise billing will affect hospital billing processes starting in 2022.
Government agencies issue the first set of regulations restricting surprise billing
In a development that many healthcare stakeholders have awaited for months, four federal agencies on Thursday, July 1 released new regulations prohibiting surprise billing in many scenarios.
Healthcare News of Note: S&P says outlook is stable for not-for-profit healthcare sector
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: The not-for-profit healthcare sector outlook was upgraded to stable, new research explores the higher risks facing certain racial and ethnic groups during COVID-19, and OIG finds that CMS lacks the tools to assess hospital quality and safety during an infectious disease outbreak.
Healthcare leaders offer direction on key CMS inpatient proposals for FY 2022
HFMA offers direction to CMS on several of its key inpatient proposals for 2021 as many healthcare leaders have expressed concern about these proposals.
Hospital groups raise red flags about spending offsets in bipartisan infrastructure bill
The bill would be paid for in part by extending the duration of the 2% reduction in Medicare payments and by tapping into the Provider Relief Fund.
Medicare should update its policies for separately payable drugs in the Outpatient Prospective Payment System, MedPAC says
Worthwhile changes include requiring drugs to be proven clinically superior before granting them pass-through payment status, according to a new report.