Healthcare costs for Americans are climbing higher once again following slower growth and even a rare decrease during the COVID-19 pandemic, according to the latest Milliman Medical Index (MMI)...
Paging subject matter experts for denial management.
According to a recent survey from healthcare AI vendor AKASA and the Healthcare Financial Management Association (HFMA), denial management requires...
Enacting scheduled cuts to Medicaid Disproportionate Share Hospital (DSH) payments would leave the most vulnerable patients and providers open to more access to care problems, a bipartisan group of...
Inpatient rehabilitation facilities (IRFs) will have their Medicare claims reviewed either before or after payment as part of a demonstration CMS intends to take nationwide.
CMS recently announced on...
This week, the American Hospital Association (AHA) told Congress ways to improve hospital price transparency initiatives and compliance.
The United States House Ways and Means Committee earlier this...
Nearly a year after the federal government launched the independent dispute resolution (IDR) process under the No Surprises Act, over 330,000 balance billing disputes have been filed, nearly 14 times...
As Medicare Advantage enrollment grows, medical practices are experiencing more prior authorization burdens, including higher administration costs and disrupted workflows, a report from the Medical...
Participation in the 340B drug pricing program was associated with reduced biosimilar use and more biologic administrations, a study published in Health Affairs found.
The 340B program allows eligible...
Health inequity is costing the Medicare program more than $60 million on preventable heart failure hospital admissions, suggests a new study out of Tulane University.
The study published in the most...
The American Medical Association (AMA) and more than 100 other provider trade associations have taken issue with a new policy from The Cigna Group regarding claims with modifier 25.
Cigna recently...
Three major credit bureaus are giving consumers a break when it comes to medical debt. Equifax, Experian, and TransUnion jointly announced yesterday that any medical debt collection with an initial...
The American Academy of Ophthalmology (the Academy) has offered recommendations to CMS on the Medicare Advantage prior authorization proposed rule that may help reduce provider burden and improve...
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...
A study of negotiated rates under the new hospital price transparency rule has identified the most expensive type of hospital to receive a brain MRI.
Since Jan. 1, 2021, the federal government has...
The Medicare Payment Advisory Committee (MedPAC) recommended increasing physician payment rates based on an inflation-based index for Medicare.
The independent advisory group suggested in its March...
The American College of Rheumatology (ACR) commended CMS for its proposed prior authorization policies but asked the agency to expand its guidance to other utilization management tools and shorten the...
Practices are completing more prior authorizations compared to last year and seeing more care delays as a result, according to new data from the American Medical Association (AMA).
The AMA recently...
President Biden has announced plans to extend the solvency of the Medicare Trust Fund by at least 25 years in the fiscal year (FY) 2024 budget.
The budget includes proposals to stretch the solvency of...
Evaluation and management (E/M) payment policy changes implemented in 2021 resulted in higher Medicare reimbursement for most physicians but only led to a modest decrease in the payment gap between...
Hospital and health system advocates are calling on lawmakers to stop an $8 billion cut to Medicaid Disproportionate Share (DSH) payments to safety-net hospitals.
A letter sent to Congressional...
