Insurance companies are negotiating rates for hospital services that are higher than the cash price and the same service can also have a wide price range even within the same hospital, according to an ...Read More »
Those working in healthcare should not expect many more fully risk-based payment models from the Center for Medicare and Medicaid Innovation (CMMI), CMS Chief Operating Officer Jon Blum said during the National Association of Accountable Care...Read More »
The Medicare 2022 Physician Fee Schedule includes CPT codes for remote therapeutic monitoring, suggesting that telehealth policies implemented in response to COVID-19 may be here to stay. According to...Read More »
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 »
