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

Healthcare Policy

Hospitals Seek Another Delay for $4B Medicaid DSH Payment Cut

February 22, 2019 - America’s Essential Hospitals, American Hospital Association (AHA), Association of American Medical Colleges (AAMC), and five other national hospital groups are calling on policymakers to implement another delay for scheduled cuts to Medicaid Disproportionate Share Hospital (DSH) allotments. The Affordable Care Act (ACA) requires policymakers to reduce Medicaid DSH payments. At...


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Healthcare Price Transparency in NH Reduced Out-of-Pocket Costs

by Jacqueline LaPointe

Healthcare price transparency shifts care to lower-cost providers and saves consumers and payers money, according to a recent study out of the University of Michigan. Costs fell by five percent for patients and four percent for insurers...

Would New Care Access Standards Pave the Way for VA Privatization?

by Jacqueline LaPointe

Veterans may be able to seek more private healthcare under a new proposed rule from the Department of Veterans Affairs (VA), which Secretary Robert Wilkie says is a move to improve care quality for veterans, not VA privatization. Released...

Some Health Services to Resume Under New Government Shutdown Deal

by Jacqueline LaPointe

After 35 days of a partial government shutdown, President Trump and Congressional leaders reached a deal to reopen the government for three weeks. President Trump anticipates signing the deal as soon as Friday, Jan. 25, 2019 to restore...

CMS: We Must Do More Than New Healthcare Price Transparency Rule

by Jacqueline LaPointe

Hospitals may have to publish a list of their standard charges online, but that doesn’t have to be their only step to increase healthcare price transparency, CMS Administrator Seema Verma recently stressed. “While many...

Prices Still Responsible for High US Healthcare Spending

by Jacqueline LaPointe

Prices are still the primary reason healthcare spending in the US more than doubled from 2000 to 2016, revealed a new follow-up study to the landmark 2003 article titled “It’s the Prices, Stupid.” The article’s...

Healthcare Interoperability, Rule Reform Key to Value-Based Payment

by Jacqueline LaPointe

Healthcare interoperability is vital to the transition to value-based payments, the second in command at HHS recently stated at the Office of the National Coordinator for Health Information Technology (ONC) annual...

AHA, AAMC Sue HHS Over Site-Neutral Payment Expansion

by Jacqueline LaPointe

The American Hospital Association (AHA), Association of American Medical Colleges (AAMC), and three healthcare organizations are suing HHS over a new site-neutral payment policy slated to take effect on January 1, 2019. The site-neutral...

HHS Unveils Plans to Increase Healthcare Competition, Choice

by Jacqueline LaPointe

Deregulation is at the top of HHS’ mind, according to a new blueprint on increasing healthcare competition and choice from several White House agencies. HHS, along with the Departments of the Treasury and Labor, the Federal Trade...

HHS to Implement 340B Drug Price Ceiling, Penalties in Jan 2019

by Jacqueline LaPointe

After several delays, HHS will implement drug price ceilings and civil monetary penalties for manufacturers under the 340B Drug Pricing Program in 2019, according to a final rule from the HHS agency, Health Resources and Services...

CMS Advances Healthcare Price Transparency With Comparison Tool

by Jacqueline LaPointe

CMS is advancing its healthcare price transparency efforts through a new online tool that allows healthcare consumers to compare Medicare payments and copayments for certain surgical procedures. The recently launched Procedure Price...

Medicare Reimbursement Rules Limit Telehealth Adoption

by Jacqueline LaPointe

Telehealth utilization among Medicare beneficiaries is on the rise, but restrictive Medicare reimbursement rules are stifling the adoption of such services, a new report shows. The CMS report on Medicare telehealth utilization between...

92% of Providers Concerned About Hospital Price Transparency Rule

by Jacqueline LaPointe

Ninety-two percent of healthcare providers are concerned about the new hospital price transparency requirement recently finalized by CMS, a new poll shows. CMS finalized the hospital price transparency requirement in the 2019 Inpatient...

Site-Neutral Payments for Hospital Clinic Visits Starting in 2019

by Jacqueline LaPointe

Hospitals will face site-neutral payments for clinic visits, but not for new clinical families of services, according to the new final 2019 Hospital Outpatient Prospective Payment System (OPPS) rule. CMS recently finalized the contentious...

CMS Clarifies Healthcare Price Transparency Rules for Hospitals

by Jacqueline LaPointe

CMS recently expanded on new healthcare price transparency requirements for hospitals in a series of frequently asked questions (FAQs) published on its website. The FAQs cover which hospitals are subject to the new requirements, the...

CMS Floats Rule to Save Providers $1.1B, Cut Administrative Burden

by Jacqueline LaPointe

Healthcare providers are slated to save an estimated $1.12 billion annually under a recently proposed rule from CMS that would reduce administrative burdens. The savings would stem from proposals to simplify and streamline...

Policymakers Concerned with ACO Shared Savings Under Updated MSSP

by Jacqueline LaPointe

The House Committee on Ways and Means recently voiced concerns that proposed changes to the shared savings arrangements under the Medicare Shared Savings Program (MSSP) overhaul would harm accountable care organizations (ACOs). In a...

ACOs Relax Post-Acute Care Rules to Improve Care, Reduce Costs

by Jacqueline LaPointe

Ensuring patients receive the right post-acute care at the right time is key to controlling costs in accountable care organizations (ACOs) and other population-based alternative payment models. With this in mind, Vermont’s statewide...

AHA: Create Stark Law Exception for Value-Based Reimbursement

by Jacqueline LaPointe

The American Hospital Association (AHA) recently urged CMS to modify the Stark Law by adding value-based reimbursement exceptions that enable providers to coordinate care and advance patient outcomes.   “To reach the full...

CMS Finalizes Hospital Price Transparency Rules, 3% Payment Boost

by Jacqueline LaPointe

CMS recently finalized a rule that will establish more comprehensive healthcare price transparency rules for hospitals. In the final rules on the Medicare prospective payment systems for the inpatient (IPPS) and long-term care (LTCH PPS)...

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