Policy & Regulation

Over One Third of Physicians Disagree with COVID Vaccine Mandate

by Sarai Rodriguez

The Adaptive Medical Partners (AMP) conducted survey of over 1,000 physicians and clinicians from their network to gather insight regarding the impact of the COVID-19 vaccine mandate for healthcare...

CMS Issues COVID-19 Vaccine Mandate for Healthcare Workers

by Jacqueline LaPointe

CMS has issued the interim final rule with comment period requiring all healthcare workers to get a COVID-19 vaccine. The rule mandates vaccinations of eligible staff at healthcare facilities...

Texas Medical Association Sue Feds Over IDR for Surprise Billing

by Jacqueline LaPointe

The Texas Medical Association is taking action against a regulation slated to implement the No Surprises Act, a federal surprise billing law taking effect on January 1st. The Association recently...

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...

Hospital Price Transparency Penalties to Increase Under OPPS Rule

by Jacqueline LaPointe

Starting January 1, CMS will increase penalties for noncompliance with hospital price transparency requirements under the newly released Calendar Year (CY) 2022 Hospital Outpatient Prospective Payment...

CMS Updates End-Stage Renal Disease APM, PPS to Address Health Equity

by Jacqueline LaPointe

UPDATED CMS has made changes to the End-Stage Renal Disease (ESRD) alternative payment model, ESRD Treatment Choices, to directly address health equity. The ESRD Treatment Choices (ETC) Model is...

Nearly $27B Remains in Provider Relief Fund, Analysis Shows

by Jacqueline LaPointe

There are still tens of billions of dollars sitting the Provider Relief Fund, a pool of grants specifically for healthcare providers who have reported or are still experiencing pandemic-related losses...

Prior Authorizations Beat COVID Workplace as Top Regulatory Burden

by Jacqueline LaPointe

Prior authorizations are troubling medical groups more than regulations governing the workplace during COVID-19 and Medicare’s Quality Payment Program, according to survey results from the...

Physician Compensation, Staffing to Take Big Hit from 10% Medicare Cut

by Jacqueline LaPointe

Healthcare organizations are planning to reconsider physician compensation, hiring, and other initiatives if Congress does not stop looming Medicare payment cuts. Almost half (47 percent) of medical...

Surprise Billing Regulation a Gift to Payers, Blow to Providers

by Jacqueline LaPointe

The American Medical Association (AMA) is calling the latest in a series of surprise billing regulations “an undeserved gift to the insurance industry that will reduce [healthcare] options for...

Independent Dispute Resolution Detailed in New Surprise Billing Rule

by Jacqueline LaPointe

The Biden-Harris Administration has released a long-awaited interim final rule that will explains how payers and providers will agree on an out-of-network rate when surprise billing occurs. The rule...

CMS to Repeal Medicare Coverage of Breakthrough Devices Rule

by Jacqueline LaPointe

CMS has proposed repealing a Trump-era rule that sought to deliver faster Medicare coverage for medical devices designated as "breakthrough" by the Food and Drug Administration (FDA). The rule also...

HHS Proposes More Surprise Billing Compliance Rules

by Jacqueline LaPointe

HHS and other federal departments have released a notice of proposed rulemaking (NPRM) that would impose civil monetary penalties of up to $10,000 on providers and facilities with surprise billing...

HHS Announces Plan to Distribute $25.5B in COVID-19 Provider Relief

by Jacqueline LaPointe

HHS will distribute $25.5 billion in COVID-19 provider funding, including $8.5 billion from the American Rescue Plan for rural providers and a fourth round of general Provider Relief Fund distribution...

CMS to Tie Vaccine Mandate to Medicaid, Medicare Participation

by Jacqueline LaPointe

A COVID-19 vaccine mandate for healthcare workers will be tied to Medicaid and Medicare Conditions of Participation (CoP), the Biden-Harris Administration recently announced. The announcement made via...

Revenue-Based COVID-19 Funds Failed to Help Some Hospitals in Need

by Jacqueline LaPointe

Congress allocated $178 billion to the Provider Relief Fund to help hospitals overcome the financial and operational challenges of the COVID-19 pandemic. But the primary distribution method for the aid...

Hospitals Still Waiting on Remaining COVID-19 Provider Relief Funds

by Jacqueline LaPointe

The American Hospital Association (AHA) is urging HHS to distribute billions of dollars still sitting in the COVID-19 Provider Relief Fund. The Sept. 2 special bulletin from the AHA said that it...

What the No Surprises Act Means for Providers

by Emily Sokol, MPH

In December 2020, Congress passed the No Surprises Act to reduce unexpected medical bills on patients. But implementing the regulations by the January 2022 deadline might be a challenge for...

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,...

What Revenue Cycle Can Do to Prepare for Surprise Billing Compliance

by Jacqueline LaPointe

A prohibition on surprise billing is coming at the start of next year and federal agencies have started to release what surprise billing compliance will look like. These new compliance requirements...