Reimbursement News

Hospital Medicare Payments Dwarf Surgical, Add to Price Hikes

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Even as length of stay decreased for hip fracture patients, the disparity between Medicare reimbursements to hospitals and reimbursements to surgeons has grown in recent years for this procedure,...

2% Hospital Reimbursement Hike, Other 2022 MedPAC Recommendations

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In its annual March report to Congress, the Medicare Payment Advisory Commission (MedPAC) has recommended a 2 percent increase in Medicare hospital reimbursement rates in 2022 and no update for...

CMS Boosts Medicare Reimbursement for COVID-19 Vaccinations

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UPDATED 03/16/21 CMS has significantly increased Medicare reimbursements rates for the administration of new COVID-19 vaccines in an effort to accelerate rollout, according to a new...

MA Reimburses 2X Medicare Rate for Some COVID-19 Vaccinations

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Healthcare providers in Massachusetts are getting twice the standard Medicare rate for COVID-19 vaccinations in an effort to accelerate vaccine rollout, according to a recent provider bulletin from the...

Skilled Nursing Facility Staffing Impacted by New Payment Rules

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Skilled nursing facility (SNF) staffing levels across several provider types have fallen since Medicare implemented new payment rules meant to drive value over volume of services, according to a new...

AMA: Medicare Sequester Threatens Physician Practice Viability

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As Congress gets ready to pass another COVID-19 stimulus package this week, physicians are once again calling on lawmakers to consider extending the moratorium of the Medicare sequester in a bid to...

Major Physician Reimbursement Gap for Independent Versus Hospital Docs

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Physician reimbursement for services performed by a doctor working for a hospital or health system is significantly higher than that paid to independent physicians for the same services, according to a...

Physician Specialties Hit Hardest by Medicare Spending in 2020

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Medicare spending on physician services decreased by $9.4 billion, or 19 percent, in the first half of 2020 because of the COVID-19 pandemic, according to a new analysis from the American Medical...

Hospital Uncompensated Care Costs Down After LA Medicaid Expansion

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After Medicaid expansion in Louisiana, hospital uncompensated care costs decreased by about a third—significantly more compared to some other expansion states—with public and rural...

Reimbursing at Medicare Rates to Cut Healthcare Spending by $352B

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Healthcare spending would be about $352 billion lower in 2021 if private payers reimbursed providers at Medicare rates, according to a new analysis from Kaiser Family Foundation. The analysis of data...

Biden Administration Recommits to COVID-19 Reimbursement

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The Biden administration will provide COVID-19 reimbursement to clinicians vaccinating uninsured patients, according to new CMS guidance. The guidance released on Feb. 26, 2021, stated that providers...

Hospitals Increasingly Billing Inpatient Stays at Highest Severity

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A new report from the HHS Office of the Inspector General (OIG) has shown that hospitals have increasingly billed inpatient stays at the highest severity level, causing concern about Medicare...

COVID-19 Hospital Revenue Losses Could Reach Up to $122B in 2021

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Total hospital revenue will take a significant hit compared to pre-pandemic levels, spelling trouble for ongoing COVID-19 vaccination efforts, according to a new analysis. The analysis prepared by...

Hospital Price Transparency to Save Just $8.7B to $26.6B a Year

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Hospital price transparency policies are slated to save between $8.7 billion to $26.6 billion a year, but that may not make a big enough dent in the $1.2 trillion—and growing—hospital...

States Make Progress with Telehealth Reimbursement Laws

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The COVID-19 pandemic has resulted in a significant increase in state telehealth reimbursement laws, but more progress can still be made to address the biggest barrier to telehealth adoption, lawyers...

Hospitals Ask Supreme Court to Take Up 340B, Site-Neutral Payments

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The American Hospital Association (AHA), joined by member hospitals and other national organizations, have filed petitions asking the Supreme Court to reverse two appeals court decisions impacting...

Primary Care Needs Telehealth Reimbursement, Targeted Relief

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Better-targeted federal relief, continued telehealth reimbursement, and help acquiring personal protective equipment are some ways primary care providers can maintain financial stability as the...

Medicaid Physician Reimbursement Rates Lag Medicare

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Medicaid physician reimbursement is significantly lower than commercial payer and even Medicare payments for the same services despite growing enrollment in the public healthcare program, reveals a new...

AHA Decries UnitedHealthcare’s Diagnostic, Drug Coverage Policies

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The American Hospital Association (AHA) is seeking immediate relief from UnitedHealthcare’s new benefit design program that would restrict in-network diagnostic providers. The hospital group...

Claim Automation Up, But $16.3B Remains in Potential Savings

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Levels of claim automation have risen in healthcare over the past year, but so has the opportunity for further savings through technology, the Council for Affordable Quality Healthcare, Inc. (CAQH)...