Physician Reimbursement

Texas Federal Judge Rules Against HHS in Surprise Billing Lawsuit

by Victoria Bailey

4/26/2022 update: This article has been updated to include the decision from HHS to appeal the ruling. A federal judge in Texas has ruled in favor of the Texas Medical Association (TMA) in a surprise...

Physician Compensation Still Hinges on Volume at System-Owned Practices

by Jacqueline LaPointe

Despite a decades-long push toward value-based payment, physician compensation arrangements at health system-owned practices still primarily revolves around the volume of services delivered, according...

AMA Challenges MedPAC Suggestion to Freeze Medicare Physician Payment

by Sarai Rodriguez

The American Medical Association (AMA) published a statement criticizing the Medicare Payment Advisory Commission’s (MedPAC’s) stance on Medicare physician payments next...

Providers Dodged Major Medicare Payment Cuts But More Work To Be Done

by Jacqueline LaPointe

Healthcare providers have evaded a nearly 10 percent reduction to their Medicare payments in 2022 thanks to swift Congressional action. However, more work still needs to be done to support physicians and hospitals as they navigate a...

Legislation Stopping Medicare Payment Cuts Clears Congress

by Jacqueline LaPointe

UPDATE 12/10/2021: In a 59 to 35 vote on Thursday, the Senate passed legislation that will prevent statutory Medicare payment cuts from taking effect next year. The bill cleared the House earlier this...

House Dems Look to Prevent Medicare Payment Cuts

by Jacqueline LaPointe

UPDATE 12/08/2021: A deal has been reached to avert some of the pending Medicare payment cuts. Congressman Steven Horsford (D-NV) and Congresswoman Kim Schrier (D-WA) introduced the...

Studies Find Physician Compensation Gaps By Setting, Gender

by Jacqueline LaPointe

Physician compensation may hinge on your gender and where you practice, two studies published in the December 2021 edition of Health Affairs suggest. One study analyzed data from over 80,000 full-time...

Automatic MIPS Participation Exemption for Individual Eligible Clinicians

by Jacqueline LaPointe

CMS is exempting all individual eligible clinicians from Merit-Based Incentive Payment System (MIPS) participation in the 2021 performance year (PY). The eligible clinicians will receive an automatic...

CMS Releases Final Rule for CY 2022 Medicare Physician Fee Schedule

by Jacqueline LaPointe

UPDATED CMS has finalized the calendar year (CY) 2022 Medicare Physician Fee Schedule to promote greater telehealth utilization, boost reimbursement rates for vaccine administration, and improve...

HRSA Opens Application for Provider COVID-19 Relief Funds

by Victoria Bailey

The Health Resources and Service Administration (HRSA) has opened the portal for healthcare providers to apply for part of $25.5 billion in COVID-19 relief funds. The American Rescue Plan Act will...

Financial Incentives for Medical Assistants May Improve Care Delivery

by Victoria Bailey

Financial incentives for medical assistants have the potential to increase their motivation at work and improve the quality of the care they provide, according to a study in The Annals of Medicine....

AMGA Pushes Congress to Prevent 10% Medicare Payment Cut

by Jacqueline LaPointe

Medical groups are urging Congress to prevent significant cuts to Medicare payment that could be triggered by recent spending bills and a proposed rule from CMS. In a letter to Congressional leaders,...

Physician Compensation Creeps Up While Productivity Dives

by Jacqueline LaPointe

Physician compensation increased modestly as a result of the COVID-19 pandemic, while productivity took a sharp decline, AMGA (American Medical Group Association) reports. A survey conducted by AMGA...

The Good and Bad of the Medicare Physician Fee Schedule Proposal

by Jacqueline LaPointe

Physician groups are calling the Medicare Physician Fee Schedule proposed rule a mixed bag for practices, which now face a potential reduction in physician reimbursement next year, among other...

CMS Seeks Health Equity, Telehealth in Physician Fee Schedule Rule

by Jacqueline LaPointe

CMS has proposed a new rule that would update the Medicare Physician Fee Schedule and seek more health equity and telehealth utilization among physicians. The proposed rule would establish a new...

HHS: $4.8B to COVID-19 Testing Reimbursement for the Uninsured

by Jill McKeon

Under the Health Resources and Services Administration (HRSA), HHS announced it will allocate $4.8 billion to COVID-19 testing reimbursement for the uninsured as part of the American Rescue...

HHS Paying Providers for Underinsured Vaccine Administration

by Jacqueline LaPointe

HHS has announced a new program designed to reimburse providers for administering COVID-19 vaccines to underinsured patients. The COVID-19 Coverage Assistance Fund (CAF), launched Monday through the...

Mass. Healthcare Spending Increases, Premiums, Cost-Sharing Slow

by Hannah Nelson

Massachusetts experienced higher-than-expected total healthcare spending growth in 2019, however rates of commercial insurance premiums and member cost-sharing decelerated from 2018, according to the...