Medicare Compliance

Hospital Price Transparency Higher in Less Competitive Markets

by Victoria Bailey

Hospitals with greater market shares and those in less competitive regions had higher compliance with the payer-specific negotiated prices requirement of the hospital price transparency rule, according...

Georgia Hospitals Fined for Hospital Price Transparency Violations

by Victoria Bailey

Two Georgia hospitals have received fines from CMS for violating the hospital price transparency rule. Following unanswered warning notices, CMS sent notices of imposition of a civil monetary penalty...

Top-Ranked Hospitals Not Complying with Price Transparency Rule

by Victoria Bailey

Top-ranked hospitals are not complying with the CMS hospital price transparency rule, as many facilities have failed to report complete pricing data for common shoppable services, according to a report...

Assessing Progress on the Hospital Price Transparency Rule

by Victoria Bailey

The Centers for Medicare and Medicaid Services (CMS) established the hospital price transparency rule to help individuals know the cost of a hospital item or service before receiving it. CMS proposed the price transparency rule in the...

Senate Voted to Repeal COVID-19 Healthcare Worker Vaccine Mandate

by Victoria Bailey

The Senate has approved a resolution that seeks to repeal the COVID-19 healthcare worker vaccine mandate. The House of Representatives has not made such a vote, meaning as of now the vaccine mandate...

50% of Hospitals Meet Price Transparency Rule for Lumbar Spine MRI

by Victoria Bailey

Only 50 percent of hospitals that offered lumbar spine MRI services were compliant with the CMS hospital price transparency rule, according to a study from Harvey L. Neiman Health Policy...

Only 14% of Hospitals Met Price Transparency Rule Compliance

by Victoria Bailey

Less than 20 percent of hospitals are complying with the CMS price transparency rule that went into effect on January 1, 2021, according to a report from PatientRightsAdvocate.org. The hospital price...

Practices Not Ready to Implement NSA’s Good Faith Estimates

by Jacqueline LaPointe

Physician practices are struggling to comply with the No Surprises Act’s good faith estimate requirements, which went into effect on Jan. 1, 2022. The new federal law requires all providers to...

Where Hospital Price Transparency Compliance Is Lagging

by Sarai Rodriguez

Hospital price transparency requirements aim to unveil healthcare pricing and support a consumer-oriented healthcare industry. However, hospital price transparency compliance is falling short,...

Vaccine Mandate for Healthcare Workers Enforceable in All States

by Jacqueline LaPointe

A federal judge in Texas has dismissed the state’s challenge of CMS’ vaccine mandate for healthcare workers, paving the way for the federal agency to enforce the mandate across the...

CMS Updates Healthcare Worker Vaccine Mandate Guidance

by Jacqueline LaPointe

CMS has issued interpretative guidance on its healthcare worker vaccine mandate following the Supreme Court’s decision to allow the mandate to be enforced while some states challenge it in...

AHA Shares New Concerns with Vaccine Mandate for Healthcare Workers

by Sarai Rodriguez

A comment letter from the American Hospital Association (AHA) to CMS requested changes and increased clarity concerning the agency’s COVID-19 vaccine mandate for healthcare...

Appeals Court Allows Healthcare Vaccine Mandate in 26 States

by Jacqueline LaPointe

The US Court of Appeals for the Fifth Circuit has allowed CMS to enforce the vaccine mandate specific to healthcare workers to resume in about half of the country. Although, the decision released on...

Some Hospitals, Health Systems Go Back on Vaccine Mandates

by Jacqueline LaPointe

Major hospitals and health systems that previously implemented COVID-19 vaccine mandates have lifted requirements their staff get the jabs in order to work. Some of the organizations include HCA...

CMS Suspends COVID-19 Vaccine Mandate for Healthcare Workers

by Jacqueline LaPointe

CMS has officially suspended the COVID-19 vaccine mandate for healthcare workers following two court orders to pause the interim final rule implementing the mandate from the Biden...

CMS Provides Guidance on Good Faith Estimates for No Surprises Act

by Jacqueline LaPointe

CMS has released 11 documents to help providers comply with the No Surprises Act’s requirement that providers give patients a “good faith estimate” of expected charges. The No...

Courts Block COVID-19 Vaccine Mandate for Healthcare Workers

by Jacqueline LaPointe

UPDATE 12/01/2021: Louisiana District Court Judge Terry Doughty has temporarily blocked the Biden Administration's COVID-19 vaccine mandate for healthcare workers in more states. The...

Study: 30% of Healthcare Workers Not Fully Vaccinated

by Sarai Rodriguez

An estimated 30 percent of healthcare workers were not fully vaccinated against COVID-19 as of September 2021, according to a CDC analysis published in the American Journal of Infection Control. The...

Medicare FFS Improper Payment Rate Hits Low of 6.26%

by Jacqueline LaPointe

CMS continues to control improper payments in Medicare fee-for-service (FFS). The federal agency recently announced that the 2021 Medicare FFS improper payment rate hit a historic low of 6.26 percent...

CMS Sued by Ten States Over Vaccine Mandate for Healthcare Workers

by Sarai Rodriguez

Ten states led by Missouri Attorney General Eric Schmitt and Nebraska Attorney General Doug Peterson have filed a lawsuit against CMS and the Biden Administration challenging the COVID-19 vaccine...