Regulatory News

Healthcare Transparency Bill Proposes to Delay Star Ratings

July 27, 2016 - Two House Representatives, Jim Renacci (R-OH) and Kathleen Rice (D-NY), have recently introduced a healthcare transparency bill that would require CMS to delay the release of new hospital star ratings for another year to ensure that the program’s methodology is fair and accurate. A summary of the Hospital Quality Rating Transparency Act of 2016...


Articles

AHA: Healthcare Fraud Laws Impede Value-Based Care Success

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For alternative payment models under MACRA to succeed, the federal government needs to revise healthcare fraud and abuse prevention laws to work with new value-based care strategies, explained the...

House Reps Introduce Healthcare Transparency, Cost Info Bill

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With more individuals covered by a health insurance plan and high-deductible arrangements on the rise, patients and beneficiaries are increasingly demanding more healthcare transparency when it comes to...

Medicare Payment Reform Bill for Hospitals Moves to Senate

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The House of Representatives recently passed the Helping Hospitals Improve Patient Care Act, which proposes Medicare payment reform for off-campus hospital outpatient departments, hospitals with...

Newly Launched MACRA Initiative Aims to Support Providers

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On May 25, American Medical Group Association (AMGA) launched a resource to help its members prepare for MACRA implementation as well as all risk-based payment systems. “We are making it our...

Proposed Bill Seeks Medicare Payment Reform for Hospitals

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Potential reform is coming to help hospitals avoid getting penalized for high admission rates among low-income patient populations. On May 18, two members of the House of Representatives Health...

For Truly Value-Based Care, Use Outcomes Instead of Processes

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Value-based care is the goal of many of the nation’s healthcare reform efforts, yet basing regulatory changes and provider-facing metrics on checking off processes instead of achieving outcomes...

AHA: MACRA Alternative Payment Model Incentives Need Changing

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The MACRA Alternative Payment Model incentives should be implemented in a way that provides the best opportunity for physicians to become qualifying participants, the American Hospital Association argued...

How MACRA, MIPS Will Impact Critical Access Hospitals, FQHCs

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MACRA means different things to various types of healthcare providers, such as critical access hospitals, rural health clinics and Federally Qualified Health Centers. Although the new MACRA framework...

Top 5 Facts to Know about MACRA Alternative Payment Models

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CMS recently proposed a rule that would put last year's MACRA's legislation into action. The proposal introduces several significant changes to the way providers will attest to quality...

CMS Proposes New Quality Reporting for Skilled Nursing Facilities

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CMS is hoping to bring more value-based care to skilled nursing facilities by issuing a proposed rule that raises the bar on quality reporting programs for these providers. As part of the Improving...

Providers Need Time, Resources for MACRA Implementation

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Driven by the Affordable Care Act, the implementation of Medicare Access and CHIP Reauthorization Act (MACRA) is expected to significantly impact the nation's healthcare system. Already, many...

Patient Scheduling Still Problematic at VA Medical Settings

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In a perfect world, the Department of Veterans Affairs’ (VA) patient scheduling system works effectively so veterans are able to access primary care physicians easily. Unfortunately, many veterans...

States Could Build Upon the Affordable Care Act to Cut Costs

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The Affordable Care Act has had two main goals for the healthcare system: Increase health insurance coverage for Americans and lower healthcare spending around the country. At this point in time, the...

Does Medicaid Expansion Improve Revenue of Hospitals?

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The Affordable Care Act and Medicaid expansion has had a significant impact on hospitals around the country since full coverage for millions of Americans would lead to greater utilization of healthcare...

Health Insurance Exchange Tips for Taxpayers Before April 15

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With the deadline for filing this year’s taxes just around the corner, it is useful for insurance consumers to refresh the requirements of tax filing when covered through the health insurance...

Lack of Medicaid Expansion Leads to Hospital Revenue Loss

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Ever since a number of states refused to expand their Medicaid programs and receive the majority of funding for this enterprise from the federal government, there has been a division of revenue between...

Price Transparency Still Missing from Hospital Revenue Cycle

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The Affordable Care Act’s (ACA) numerous price transparency provisions are inefficient, says a policy brief from the Pioneer Institute. Hospital executives must make consumer-friendly pricing...

CMS Rule Addresses Medicare Fraud, Overpayment Compliance

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The Centers for Medicare & Medicaid Services (CMS) published a final rule this week focused on improving Medicare compliance, reporting, and self-identified overpayments to...

The Affordable Care Act’s Effect on Hospital Charity Care

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Hospitals provide charity care according to patients’ income levels. But policies and patient criteria often vary depending on the particular hospital. Supporting hospital charity care while...