New guidance for No Surprises Act arbitration looks like an improvement for providers
Responding to a recent court ruling, the U.S. Department of Health and Human Services (HHS) has updated the application of criteria for deciding No Surprises Act (NSA) independent dispute resolution (IDR) cases. Certified IDR entities (i.e., arbitrators) received guidance March 17 instructing them to more directly consider multiple factors when deciding on an out-of-network payment…
(Updated 2) Texas court again backs providers in No Surprises Act independent dispute resolution litigation
A physician association continues to roil the No Surprises Act’s arbitration process through successful litigation. For the second time in a year, the Texas Medical Association (TMA) prevailed in court after arguing that regulations governing the independent dispute resolution (IDR) process do not comply with legislative intent. Barring a successful appeal, the Feb. 6 ruling…
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.
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…
Massive federal spending bill alleviates reimbursement concerns for hospitals, but less so for physicians
Healthcare provider advocates applauded the inclusion of key reimbursement relief measures and other policies in a proposed federal spending bill for FY23, although physician groups expressed concern about the outlook for their constituents. With a divided Congress looking to muster the votes to pass the legislation before a self-imposed deadline of week’s end, the bill includes many…
CY 2023 Physician Fee Schedule Final Rule Summary Part III – Quality Payment Program Updates
HFMA presents Part III of three detailed summaries of the final rule relating to the Medicare physician fee schedule for CY 2023 and other revisions to Medicare Part B policies.
CY 2023 Physician Fee Schedule Final Rule Summary Part II – Medicare Shared Savings Program Requirements
HFMA presents Part II of three detailed summaries of the final rule relating to the Medicare physician fee schedule for CY 2023 and other revisions to Medicare Part B policies. Part II covers the Medicare Shared Savings Program Requirements.
CY 2023 Physician Fee Schedule Final Rule Summary Part I
HFMA presents Part I of three detailed summaries of the final rule relating to the Medicare physician fee schedule for CY 2023 and other revisions to Medicare Part B policies.
Nov. 11-15: HFMA’s Virtual Conference among next week’s healthcare finance events
HFMA’s Virtual Conference is among the major healthcare finance events taking place the week of Nov. 11.
Oct. 26-Nov. 1: Innovation meeting among national healthcare events
The HLTH conference in Las Vegas is pitched as the largest annual healthcare innovation conference in the nation.