The Centers for Medicare and Medicaid Services (CMS) issued proposed rules for the FY 2025 inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) payment system. The agency proposes raising payments and the industry decried the boost as insufficient.
Hospitals will receive a 2.6% increase or $2.9 billion across...National News
The exact nature of the Change Healthcare cybersecurity incident remains mysterious as concerned parties come forward to voice concerns about Change, UnitedHealth Group and the use of healthcare technologies controlled by large companies.
Last Friday, Change Healthcare announced that it would offer a temporary assistance loan program...
Last week, UnitedHealth Group's (UHG) health care technology subsidiary Change Healthcare was hit by a cyberattack that disrupted services for pharmacies and patients.
UHG said that once the attack was detected, Change was forced to disconnect some of its digital network from client access and shut down services including programs...
The American Hospital Association (AHA) and the Alliance of Community Health Plans (ACHP) are asking the Centers for Medicare and Medicaid Services (CMS) to finalize its 2025 Medicare Advantage and Part D proposed rule that would provide a number of reforms for the MA program.
In a lengthy letter highlighting several key points of the...Arizona News
Representative Ruben Gallego (AZ-03) has signed on to support the "Rural Physician Workforce Production Act," which would lift Medicare reimbursement caps on rural hospitals and incentivize urban hospitals to send residents to train at rural locations.
In a press release, Rep. Gallego noted that more than 40% of rural Arizonans worry...Top of The Day
A new report by Syntellis and the American Hospital Association (AHA) could drive the fight between hospitals and Medicare Advantage providers to reach a head, as the analysis shows MA plans' claims denials are directly contributing to declines in cash reserves.
Claims denials increased 56% for the median hospital between January 2022...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) released the CY2024 Outpatient and Ambulatory Surgical Center Prospective Payment System (OPPS), which included an increase for outpatient hospitals and ASCs of 3.1%.
The final rule's raise was larger than the 2.8% initially proposed, which the agency attributed to industry response...CMS Rules
Physicians and related stakeholder groups have rallied against the 2024 physician fee schedule proposed rule, which was issued in July. The rule is expected to be finalized shortly, but providers are saying that any cuts could jeopardize access to primary care.
The proposed rule contains a 3.36% cut to the conversion factor for...National News
The U.S. Department of Labor (DOL) has filed suit against a subsidiary of the UnitedHealth Group alleging it denied thousands of claims without reviewing them for medical necessity.
The complaint was filed in the U.S. District Court for the Western District of Wisconsin against UMR, a third-party administrator within the...Top of The Day
A new report shows that most hospitals are failing to meet the requirements of the Hospital Price Transparency Rule.
Only 36% of the 2,000 hospitals reviewed by PatientRightsAdvocate.org (PRA) were in full compliance with the rule. The report is the fifth Semi-Annual Hospital Price Transparency Compliance Report issued by the PRA....CMS Rules
The Centers for Medicare and Medicaid Services (CMS published its proposed physician fee schedule (PFS), which add up to a 1.25% decrease in pay for Medicare physicians for 2024. Physician groups and industry leaders met the news with frustration, with some doubling down on calls to reform the entire payment formula. CMS also posted the...National News
The Centers for Medicare and Medicaid Services (CMS) announced they would pay the 1,600 hospitals that participate in the 340B drug discount program a total of $9 billion in lump sum payments in response to the Supreme Court decision that found the program underpaid for prescription drugs. But the Medicare program also announced that it...
According to a new survey by the American Hospital Association (AHA), the majority of patients blame health insurance companies for barriers to healthcare.
Over 60% of patients reported that they or someone in their household had experienced a barrier to care due to their insurer and 43% of those patients reported worse health...
The report from the American Hospital Association (AHA) found from 2019 to 2022 overall hospital expenses increased by 17.5% and budgets for total contract labor expenses shot up 258% leaving facilities and systems facing extraordinary financial pressures.
From the April AHA report:
A confluence of several factors from historic...National News
The Centers for Medicare and Medicaid Services (CMS) published the FY 2024 Inpatient Prospective Payment System (IPPS) and Long-term Care Hospital Prospective Payment System (LTCH PPS) rule updates. The rule includes a 2.8% raise in operating payments for acute care hospitals.
The proposed rule updates Medicare payments and policies...National News
According to the American Hospital Association (AHA), patients requiring additional care after a hospitalization — such as skilled nursing, behavioral health or therapy-at-home — face growing delays in accessing that care.
The issue brief revealed data from Strata Decision Technology, a healthcare technology and consulting firm,...
The American Hospital Association (AHA) ran a survey of 300 hospitals and health systems to determine the overall impact of cuts made to the 340B prescription drug pricing program. It found an enormous financial impact on struggling hospitals, specifically those in rural and underserved areas.
The 340B drug pricing program requires...
The Texas Medical Association (TMA) will now lead the charge against the federal government's rules for implementing the No Surprises Act, which aims to curb surprise bills levied on patients who unknowingly or in times of emergency receive care from providers who are out-of-network for their insurance coverage.
Last week, the...
Rural hospitals and health systems have an outsized impact on the health and economic well-being of rural communities supporting one in every 12 rural jobs in America. A September report from the American Hospital Association poses solutions to preserve care in local communities.
The report considers the vital role of rural hospitals,...Arizona News
Protecting health care workers from harassment was the headline concern at a National Academies of Sciences, Engineering and Medicine (NASEM) last Thursday. The event, "The Targeting of Scientists and Public Health Professionals," was the first in a planned series that will address increases in harassment and violence toward public...