Policy and Regulation

Providers Seek to Stop Hospital Price Transparency Enforcement

by Jacqueline LaPointe

Provider groups are calling on the court to prevent hospital price transparency enforcement in the 11th hour, citing the ongoing COVID-19 pandemic. The American Hospital Association, Association of...

CMS to Audit Some Hospitals for Price Transparency Compliance

by Jacqueline LaPointe

CMS is taking steps to ensure hospitals comply with a controversial price transparency rule taking effect on January 1, 2021. On that date, every hospital in the country is expected to provide...

UPDATED: Congress Approves COVID-19 Stimulus, Gives $3B to Provider Relief Fund

by Jacqueline LaPointe

UPDATED at 12/22/2020 Congress has reached an agreement on a $900 billion COVID-19 stimulus package that was passed on Monday evening. But healthcare providers are still concerned about receiving...

US Healthcare Spending Hit High of $3.8T After Rising 4.6% in 2019

by Jacqueline LaPointe

National healthcare spending hit a total of $3.8 trillion in the year before COVID-19 hit, according to a new analysis from the Office of the Actuary at CMS. The analysis published in Health Affairs...

Providers, Lawmakers Say #StopTheCuts to Physician Fee Schedule

by Jacqueline LaPointe

With payment reductions looming for many providers paid under the Medicare Physician Fee Schedule, hundreds of medical organizations and lawmakers are pushing Congress to stop rate cuts finalized in...

Provider Groups Leery of New Surprise Billing Legislation

by Jacqueline LaPointe

A bipartisan group of Congressmembers has struck a deal over surprise billing protections for patients, but details of the draft legislation have some providers groups concerned about the bill’s...

Bipartisan COVID-19 Relief Bill Would Add to Provider Relief Fund

by Jacqueline LaPointe

A group of bipartisan policymakers has released details on a $908 billion COVID-19 relief bill that would provide more financial support for healthcare providers. According to a summary framework...

CMS Releases 2021 OPPS Final Rule, Eliminates Inpatient Only List

by Jacqueline LaPointe

CMS has released the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) final rule for 2021 in an effort to give Medicare beneficiaries more choices around surgical...

CMS Finalizes 2021 Physician Fee Schedule, Including E/M Changes

by Jacqueline LaPointe

After some delay due to the COVID-19 pandemic, CMS has released the final rule for the 2021 Medicare Physician Fee Schedule. The final rule unveiled by CMS yesterday evening will dictate how much...

CMS Hospital At Home Model Seeks to Boost Capacity During COVID-19

by Jacqueline LaPointe

As many hospitals near capacity during another surge of COVID-19, CMS is allowing some healthcare providers to participate in a new hospital at home program that allows them to deliver acute care...

New ICD-10 Codes, MS-DRG Assignments for COVID-19 Coming Jan. 1

by Jacqueline LaPointe

Come January 1, 2021, CMS will implement 21 new ICD-10 procedure codes for COVID-19 vaccines and therapeutics for the novel coronavirus, including baricitinib and monoclonal antibody treatments. The...

HHS Clarifies Debated Provider Relief Fund Reporting Requirements

by Jacqueline LaPointe

HHS is addressing Provider Relief Fund reporting requirements that have left recipients questioning how they can spend the financial aid from the federal government. The federal department clarified...

HHS Overhauls Key Healthcare Fraud Laws to Advance Value-Based Care

by Jacqueline LaPointe

After years of debate, HHS agencies have made changes to two major healthcare fraud, waste, and abuse laws that providers have said get in the way of value-based care progress. Late last week, CMS and...

Providers Say They Need More Financial Aid As COVID-19 Cases Rise

by Jacqueline LaPointe

Providers belonging to the American Medical Group Association (AMGA) are citing rising COVID-19 cases as a reason why Congress should pass additional financial assistance. In a letter sent to...

What Healthcare CFOs Can Expect Under a Biden Presidency

by Jacqueline LaPointe

For many voters, the 2020 presidential election was less about red and blue and more about white, as in the white coat. Healthcare was a dominant issue in the race between the incumbent President Donald J. Trump and Democratic runner Vice...

CMS Details Medicare Payment for New COVID-19 Antibody Drug

by Jacqueline LaPointe

Just a day after the FDA approved the emergency use of a new COVID-19 antibody drug, CMS updated Medicare payment and billing policies to ensure providers have access to the new treatment for...

Most Physicians Prefer Single-Payer Option Over Medicare For All

by Jacqueline LaPointe

Providing affordable health insurance coverage is a top goal for physicians and most believe healthcare can achieve that through a single-payer option, a new survey reveals. The final installment of...

Patients Want Healthcare Price Transparency, But Few Seek It Out

by Jacqueline LaPointe

Most consumers living in a state with some of the most comprehensive healthcare price transparency laws have never thought to seek out pricing information for provider services, according to a recent...

CMS Finalizes 1.9% Boost for Medicare Home Health Reimbursement

by Jacqueline LaPointe

CMS has finalized a 1.9 percent, or $390 million, increase in Medicare home health reimbursement in 2021. The boost in reimbursement is significantly less than the 2.6 percent increase proposed by CMS...

CMS Expands Medicare Reimbursement for Home Dialysis, ESRD

by Jacqueline LaPointe

New and innovative home dialysis machines will soon qualify for additional Medicare reimbursement, according to the latest End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) final...