Sponsored by Brault Practice Solutions
The Battle For Fair Reimbursement Under The No Surprises Act
The federal ban on surprise medical billing took effect on Jan. 1, 2022, following the passage of the No Surprises Act (NSA) in December 2020. The NSA resulted from years of negotiations and...Site-Neutral Payments Could Threaten Access to Care, Study Suggests
A new study released by the American Hospital Association (AHA) suggests that site-neutral payments could threaten access to care for some of the most vulnerable patients. Site-neutral payments...Providers are Increasingly Billing Outpatient Visits at Higher Levels
Outpatient visits are being billed at higher levels, leading to increased healthcare spending and concerns about upcoding, a Peterson-KFF Health System Tracker found. Healthcare providers can bill...Lessons from the NSA’s Independent Dispute Resolution (IDR) Process
Nearly a year since the federal government launched the independent dispute resolution (IDR) process, Becky Greenfield, partner at Wolfe Pincavage, has learned a few things about the No Surprises Act (NSA) and out-of-network claim...TX Physicians Win No Surprises Act Rule Court Case
A federal judge has ruled in favor of the Texas Medical Association’s (TMA’s) challenge of a No Surprises Act rule released by HHS to flesh out the independent dispute resolution (IDR)...Automating Claims Management Processes May Reduce Costs for Providers
Automating claims management processes could help healthcare providers curb the high spending on administrative transactions they saw in 2021, according to the 2022 Index report from the Council for...Federal IDR Process Faces More Disputes Than Expected, Backlog Growing
Payers and providers are utilizing the independent dispute resolution (IDR) process far more than the government expected to resolve disagreements about payment for items and services covered by the...Sponsored by Brault Practice Solutions
How the 2023 Physician Fee Schedule Impacts Emergency Medicine Groups
UPDATED 01/04/2022 CMS released its 2023 update of the Medicare physician fee schedule (MPFS), which impacts Medicare Part B payments for emergency services, diagnostic testing, and other...Providers, Payers In Ongoing “Tug-of-War” Over ED Coding, Study Says
There has been a significant increase in high-intensity billing for emergency care services over the last decade, according to a new study published in Health Affairs. The observational study of US...OIG: Labs Billed Medicare Part B for High Levels of Diagnostic Tests
More than 370 labs submitted Medicare Part B claims that included questionably high billing for COVID-19 and additional diagnostic tests, a report from the Office of Inspector General (OIG)...Sponsored by Brault Practice Solutions
Unpacking the No Surprises Act, Its Impact on Emergency Medicine
The federal No Surprises Act (NSA) went into effect on January 1, 2022, to protect patients from surprise medical bills. Specifically, those that may result from out-of-network (OON)...Value-Based Payment, Fee-for-Service Levels Hold Steady
Value-based payment levels barely moved in 2021, with some movement in the downside financial risk category, according to the latest data from the Health Care Payment Learning and Action Network (HCP LAN). The majority of healthcare...Home Health Agencies Get $125M Payment Boost from Medicare
Home health agencies will receive a 0.7 percent Medicare payment boost under the calendar year (CY) 2023 Home Health Prospective Payment System (HH PPS) Rate Update final rule, translating to an extra...Some State Surprise Billing Resolution Processes Favor Providers
The No Surprises Act gives states the opportunity to enforce surprise billing provisions, but most are leveraging the federal independent dispute resolution process to determine out-of-network rates,...Hospital Reimbursement Boosts Access to Birth Control Postpartum
A new study recently published in JAMA Network Open indicates that hospital reimbursement for immediate postpartum long-acting reversible contraception (LARC) leads to greater access to birth control...Sponsored by Brault Practice Solutions
