Outpatient visits are being billed at higher levels, leading to increased healthcare spending and concerns about upcoding, a Peterson-KFF Health System Tracker found.
Healthcare providers can bill...
A federal judge has ruled in favor of the Texas Medical Association’s (TMA’s) challenge of a No Surprises Act rule released by HHS to flesh out the independent dispute resolution (IDR)...
Financing healthcare organizations’ involvement in social risk interventions would require multiple funding approaches and is not guaranteed to improve the delivery of social services, according...
In a year after Medicaid disenrollment, about two-thirds of people had a period of uninsurance, according to a recent analysis from Kaiser Family Foundation (KFF).
The Families First Coronavirus...
Efforts to make the healthcare system more efficient and equitable by adjusting population-based payments for social risk factors may be missing the mark, suggests a new study from Harvard and Yale....
A federal court has decided to let HHS determine how to repay hospitals for years of 340B underpayments.
The decision issued Tuesday by the US District Court for the District of Columbia comes as a...
The American Hospital Association (AHA) has asked the Medicare Payment Advisory Commission (MedPAC) to consider higher Medicare payment updates before issuing its final recommendations, including...
Payers and providers are utilizing the independent dispute resolution (IDR) process far more than the government expected to resolve disagreements about payment for items and services covered by the...
Medicare Part B spending on laboratory tests increased by 17 percent between 2020 and 2021, resulting from high volumes of COVID-19 tests, genetic tests, and chemistry tests, a report from the Office...
A handful of providers did not comply with federal requirements when claiming Medicare bad debts, leading to nearly $30,000 in unallowable Medicare reimbursement, a report from the Office of Inspector...
Over a third of Medicaid disproportionate share hospital (DSH) payments may have been misallocated, according to a study led by Weill Cornell Medicine and University of Pennsylvania investigators.
The...
There has been a significant increase in high-intensity billing for emergency care services over the last decade, according to a new study published in Health Affairs.
The observational study of US...
Changes in Medicare payment policies and varying beneficiary characteristics drove the reduction in Medicare spending growth over the last decade, according to a study published in JAMA Health...
Seven national healthcare organizations, including the American Hospital Association (AHA) and the American Medical Association (AMA), have asked Congress to prevent the Statutory Pay-As-You-Go (PAYGO)...
The improper payment rate for the federally facilitated exchange (FFE) program was less than 1 percent in 2020, according to the annual 2022 Agency Financial Report from CMS and HHS.
Improper payments...
Disproportionate share hospital (DSH) payments from Medicare and Medicaid may further racial disparities by basing allocations on patient healthcare use, a study published in JAMA Network Open...
Poor alignment in the Medicare and Medicaid programs leads to higher spending and worse outcomes for dual eligible beneficiaries. Thus, policymakers should develop payment policies that offer a more...
A new study recently published in JAMA Network Open indicates that hospital reimbursement for immediate postpartum long-acting reversible contraception (LARC) leads to greater access to birth control...
Following a court order, CMS is revising its methodology for paying 340B hospitals for outpatient drugs and reprocessing claims paid on or before the Sept. 28th ruling.
CMS will reimburse hospitals...
Total cost per emergency department (ED) patient encounter remained unchanged at an academic medical center after it implemented an emergency department-based intensive care unit (ED-ICU), indicating...
