Reimbursement News

Gender Pay Disparities in Medicare Reimbursement Impact Neurosurgeons

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Gender pay disparities persisted for neurosurgeons between 2013 and 2020, with women receiving 44 percent less in annual payments than men, a study published in JAMA Surgery revealed. Researchers used...

MGMA: Sustainable Financing Needed to Protect Rural Healthcare

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Physician and facility reimbursement for rural practices is not sustainable and is impacting patient access to rural healthcare, the Medical Group Management Association (MGMA) tells Congress in a new...

62% of Hospitals Don’t Automate Any Part of Denials Management

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Most hospitals and health systems are not automating any component of denials management, according to a recent survey of healthcare finance and revenue cycle leaders. Commissioned by technology...

Claims Reimbursement Speed, Denial Rate Tied to Location

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Does your practice experience claims reimbursement delays? That may be because of where your practice operates, according to a recent analysis of financial transaction data. The new Crowe report,...

Firm Selection, Rollout Key Considerations of Revenue Cycle Outsourcing

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Firm selection, contracting, and rollout are among the top considerations shared by providers who recently outsourced revenue cycle management, according to a recent KLAS report. The KLAS report,...

Claim Denials Pose Expensive Problem for Providers

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Claim denials are posing a serious and expensive problem for healthcare revenue cycle management (RCM), according to a recent survey of healthcare leaders. A survey conducted by Plutus Health...

Healthcare Services Cost More at Hospital Outpatient Departments

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Costs for common medical procedures were up to 58 percent higher when they were performed in a hospital outpatient department compared to a doctor’s office, an analysis from the Blue Cross Blue...

Healthcare Orgs Address Price Transparency, 340B Policies in OPPS

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Hospital and specialty groups are urging CMS to amend aspects of the CY 2024 Outpatient Prospective Payment System (OPPS) proposed rule, including 340B Drug Pricing Program policies and price...

Provider Groups Oppose Proposed Payment Cuts in Physician Fee Schedule

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Provider organizations have made it clear they are not happy with the payment cuts CMS proposed in the 2024 Medicare Physician Fee Schedule (PFS). Additionally, groups have voiced concerns about...

AMA 2024 CPT Code Set Addresses Language Barriers, Immunization Codes

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The American Medical Association (AMA) has released the 2024 Current Procedural Terminology (CPT) code set, which addresses language barriers by including Spanish descriptors of medical services. Each...

AHA Opposes Proposed Payment Cuts for Home Health Providers

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The American Hospital Association (AHA) is urging CMS to reconsider the payment cuts included in the CY 2024 Home Health Prospective Payment System (PPS) proposed rule. Specifically, the trade...

MGMA: EFT Fees Imposed by Health Plans Are Hurting Providers

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Electronic funds transfer (EFT) fees imposed by health plans and third-party vendors are increasing costs and administrative burdens for healthcare practices, according to a position paper from the...

CMS Reduces No Surprises Act Fee After Court Vacates Price Hike

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CMS has reinstated the $50 fee for initiating a payment dispute under the No Surprises Act following a court ruling striking down a price hike earlier this year. The non-refundable administrative fee...

AHA: Site-Neutral Payment Policies Hurt Hospitals

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As healthcare prices are put under the microscope, the American Hospital Association (AHA) is criticizing a cost-cutting method to reduce prices for outpatient services. The hospital group’s...

OIG: HRSA Made Improper Payments Through COVID-19 Uninsured Program

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The Health Resources and Services Administration (HRSA) made improper COVID-19 Uninsured Program payments to providers that totaled an estimated $784 million, a report from the Office of Inspect...

Median Per Person Healthcare Spending Exceeds $6K

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Healthcare spending is still on the rise, with median costs per person increasing to over $6,000 in 2021, according to a new analysis from the Health Care Cost Institute (HCCI). Median per person...

About a Quarter of Residents in 18 States Have Medical Debt

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Medical debt is a problem for Americans, with as many as a quarter of residents in 18 states having medical debt in collections, according to a new Commonwealth Fund report. The states with the...

340B Program Enrollment Led to More Oncology Services at Rural Hospitals

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Rural hospitals that participated in the 340B Drug Pricing Program were more likely to introduce oncology services than facilities that did not enroll in the program, a study published in Health...

AHA Decries Inpatient Prospective Payment System Update

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The proposed market basket update in the Inpatient Prospective Payment System (IPPS) for the 2024 fiscal year (FY) is “woefully inadequate,” according to the American Hospital Association...

OIG: Medicare Overpayments Due to Coding Discrepancies Totaled $22.5M

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Medicare improperly paid practitioners at a higher non-facility rate for services provided to skilled nursing facility (SNF) or hospital inpatients, leading to over $22 million in overpayments, a...