Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Healthcare Policy

Pres Trump Taps Former Pharma Exec Alex Azar as Next HHS Secretary

November 14, 2017 - President Trump recently nominated Alex M. Azar II as the next HHS Secretary, according to multiple news sources. Azar was the former president of Eli Lilly’s American division and a health official in the George W. Bush Administration. If confirmed by the Senate, Azar would succeed Tom Price as head of the federal department. Price resigned in September after accusations that he spent...


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Industry Orgs Concerned with 2018 MACRA Implementation Rule

by Jacqueline Belliveau

Industry groups, including the American Medical Group Association (AMGA) and the Medical Group Management Association (MGMA), are questioning if the new 2018 MACRA implementation rule truly promotes value-based care. In recent comments on the...

CMS Cancels Home Health Groupings Model, $950M Reimbursement Cut

by Jacqueline Belliveau

CMS recently scrapped the proposed Home Health Groupings Model. The model would have used clinical and patient characteristics rather than the current therapy service use thresholds to determine Medicare reimbursement for home health agencies....

CMS Finalizes 2018 Hospital, Physician Medicare Reimbursement

by Jacqueline Belliveau

In a series of final rules released earlier this month, CMS updated and modified Medicare reimbursement rates for hospitals and physicians in 2018. The rules aim to “reflect a broader Administration-wide strategy to create a healthcare...

Hospitals, Systems Spend $39B Annually on Regulatory Compliance

by Jacqueline Belliveau

Hospitals, health systems, and post-acute care providers spend almost $39 billion annually on administrative tasks related to regulatory compliance, the American Hospital Association (AHA) reported. “As a result of this extraordinary burden,...

100+ Medical Orgs Want MACRA Implementation Flexibilities Extended

by Jacqueline Belliveau

Over 100 medical organizations recently called on House Representatives to extend MACRA implementation flexibilities that allow HHS leaders to gradually implement full program requirements. The flexibilities should go on for another three years....

Reps Eye Delay for Medicaid Disproportionate Share Hospital Cuts

by Jacqueline Belliveau

Three House Representatives recently called on their Congressional peers to postpone implementing a rule that would reduce Medicaid Disproportionate Share Hospital (DSH) payments starting on Oct. 1, 2017. The bipartisan letter from Representatives...

AHA: New Skilled Nursing Facility Payment System Needs Development

by Jacqueline Belliveau

The American Hospital Association (AHA) recently urged CMS to flesh out a proposal to implement an alternative Medicare reimbursement model for skilled nursing facilities prior to advancing the changes through official rulemaking processes. CMS...

Orgs Offer Regulatory Relief to Boost Value-Based Purchasing

by Jacqueline Belliveau

In response to the recent CMS call for stakeholder feedback on how to provide regulatory relief, industry groups detailed ways to reduce red tape associated with value-based purchasing implementation. Hospitals and individual providers have recently...

CMS Cancels Medicare Billing Changes for Partial Hospitalizations

by Jacqueline Belliveau

CMS revoked Medicare reimbursement changes to its medical billing requirements and process for partial hospitalization services, according to a recent Medicare Learning Network announcement. The federal agency originally introduced the Medicare...

CMS Ups Medicare Reimbursement for Inpatient Admissions $2.4B

by Jacqueline Belliveau

Medicare reimbursement updates and other payment policy changes finalized in a new rule from CMS will boost inpatient hospital payments by $2.4 billion in 2018 and decrease long-term care hospital payments by $110 million. “This final rule...

AMA Backs CMS Diabetes, Legacy Value-Based Purchasing Changes

by Jacqueline Belliveau

The American Medical Association (AMA) recently commended CMS for several recommendations outlined in the recently proposed 2018 Physician Fee Schedule rule. The industry group particularly welcomed a potential Medicare Diabetes Prevention Program...

Industry Orgs Back 2018 MACRA Implementation Flexibilities

by Jacqueline Belliveau

Healthcare industry organizations largely applauded the recently-released 2018 MACRA implementation proposal from CMS. The medical organizations commended the federal agency’s continuation of the transition year into 2018 as well as the...

Keep Medicare Bundled Payment Models Mandatory, Experts Say

by Jacqueline Belliveau

Switching Medicare bundled payment models that are currently mandatory in select regions to voluntary across the country would impede value-based reimbursement progress through episodic payment, industry experts warned the Trump administration...

AHA: Post-Acute Care Medicare Reimbursement Reform Needs Time

by Jacqueline Belliveau

Later this month, the Medicare Payment Advisory Commission (MedPAC) plans to vote on a draft recommendation to Congress that would accelerate the development and implementation of a unified Medicare reimbursement system for four post-acute care...

IL Supreme Court Maintains Non-Profit Hospital Tax Exemption

by Jacqueline Belliveau

The Illinois Supreme Court recently legally voided an appellate court’s decision that non-profit hospital tax exemption was unconstitutional. In Illinois, non-profit hospitals qualify for property tax exemption if the value of all charitable...

AMGA President, CEO Donald W. Fisher, PhD, Passes at 71

by Jacqueline Belliveau

AMGA President and CEO, Donald W. Fisher, PhD, CAE, passed earlier this week after battling cancer, the healthcare industry group reported. Fisher, who was 71 years old, had led the organization since 1980. “Don leaves a professional and...

NAM Advises Leaders to Prioritize Value-Based Purchasing Reform

by Jacqueline Belliveau

In a new report, the National Academy of Medicine (NAM) named value-based purchasing as one of four action priorities for healthcare stakeholders in 2017. To implement more value-based purchasing models, NAM suggested that stakeholders focus...

MedPAC Targets Post-Acute Care for Healthcare Payment Reform

by Jacqueline Belliveau

In its March 2017 report to Congress, the Medicare Payment Advisory Commission (MedPAC) pinpointed post-acute care for healthcare payment reform after Congressional and CMS inaction resulted in as much as $11 billion in lost savings since 2009....

Senate Confirms Seema Verma as Next CMS Administrator

by Jacqueline Belliveau

In a 55 to 43 vote yesterday, the Senate confirmed Seema Verma as the next CMS Administrator, according to a New York Times article. Verma, the founder, president, and CEO of a health policy consulting firm, will be charged with managing...

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