The CMS released its interim final rule on surprise medical billing, introducing a process whereby payers and providers could negotiate payments for “out-of-network” billing. Each side, however, gave the long-awaited provisions decidedly different receptions.
Sicker patients, fewer outpatient visits, and higher expenses for labor, drugs, and supplies will continue to damage the financial health of hospitals and health systems throughout 2021, says...Read More »
Twenty Medicare Advantage (MA) organizations (12%) shown to have disproportionally high payments, were reportedly responsible for more than half of the $9.2 billion total risk-adjusted payments in the year 2017, according to analysis...Read More »
Independent Health and DxID violated the False Claims Act by submitting inaccurate information about Medicare Advantage plan beneficiaries’ health status in order to increase reimbursement, according to a Department of Justice (DOJ)...Read More »
CMS has released a proposal to repeal the final rule Medicare Program; Medicare Coverage of Innovative Technology (MCIT) and Definition of “Reasonable and Necessary.” The rule sought to deliver faster Medicare...Read More »
Hospital price transparency rules and penalties don't go far enough to actually control costs, according to an expert panel assembled by the Center on Health Insurance Reforms (...Read More »
