While telehealth usage among Medicare beneficiaries has declined since the pandemic peak, more than 10% of traditional Medicare enrollees used virtual care in 2023. Providers, patients, and digital health stakeholders are urging federal lawmakers to ensure continued Medicare reimbursement for telehealth before current flexibilities...
Last week, a bipartisan group of legislators introduced a bill that would cancel the 2.83% Medicare physician pay cut and instead boost pay by 2%. Provider groups and stakeholders from across the industry have voiced support for the bill.
The bill, "Medicare Patient Access and Practice Stabilization Act," would reverse the January 1...News
Provider pay for primary care and nonsurgical specialties has risen for the fourth consecutive year according to a report by the Medical Group Management Association (MGMA).
MGMA's report framed this as part of the ongoing recovery from payment and staffing challenges posed by the COVID-19 pandemic. The report, Provider Pay and the...
The government is publicly reacting to the disruption in healthcare services caused by the Change Healthcare cyberattack and subsequent extended outage, but tangible consequences for UnitedHealth Group have yet to emerge.
The House Energy and Commerce Committee met this week to discuss the attack, but according to Modern Healthcare,...
Last Thursday, the Centers for Medicare and Medicaid Services (CMS) finalized the 2024 Medicare Physician Fee Schedule rule, which includes a 3.34% decrease to the schedule's conversion factor, setting it at $32.74, a $1.15 decrease from 2023.
The agency finalized other increases for visits including primary and longitudinal care, and...
The Medical Group Management Association (MGMA) published a report last week on the issues brought about by Medicare Advantage (MA) plans' use of prior authorization.
MGMA surveyed 600 medical groups on the use of PA and found that it contributes to increased costs and delays or denials of care. Groups overwhelmingly reported that...National News
As the Centers for Medicare & Medicaid Services (CMS) mulls making changes to prior authorization (PA) across several insurance markets, America's largest insurers are automating and speeding up the process by eliminating PA requirements for select hospitals, providers and procedures and by simplifying and automating the PA...
The Medicare Payment Advisory Committee (MedPAC) submitted its
March 2023 Report to Congress which included its 2024 payment recommendations for Medicare fee-for-service (FFS), Medicare Advantage (MA) and the Medicare prescription drug program (Part D). This year's report is likely to please no one as the committee took aim at claims of...
In December, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule that would require all health plans, including Medicare Advantage plans, to limit prior authorization deliberations to seven days. On Monday, the public comment for that rule closed.
Many providers believed that the rule doesn't go far enough,...National News
On Tuesday, the Medical Group Management Association (MGMA) released its annual regulatory burden report, which analyzes the regulatory burden placed upon providers. This year, the report highlights the issues with prior authorization, the Medicare Quality Payment Program and the No Surprises Act.
The report breaks down the responses...CMS Rules
The No Surprises Act has been a hot-button point of contention among insurers and providers as physician groups feel threatened by the leverage that insurers are given through the Act's enforcement. The Medical Group Management Association (MGMA) sent a letter to the U.S. Department of Health and Human Services (HHS) and the Centers for...National News
A new bill introduced by Representatives Suzan DelBene (D-Wash.), Peter Welch (D-Vt.), Darin LaHood (R-Ill.) and Brad Wenstrup (R-Ohio) looks to reverese Trump-era modifications to the Medicare Accountable Care Organization (ACO) program and restore higher cost savings to participating providers while removing some of the risk. The bill...National News
The Centers for Medicare and Medicaid Services alternative payment models have found immediate difficulty navigating the COVID-19 pandemic with limited resources and occasionally difficult reporting requirements, but the issues between participants in these payment models and the structures of them actually go much further back than the...National News
The report from Medical Group Management Association (MGMA) and Healthgrades.com aims to answer questions about what patients value and how they experience healthcare through the analysis of patient reviews.
Each review includes a star rating, while over a quarter include written comments. Analysis of written comments allowed...National News
The Centers for Medicare and Medicaid Services (CMS) solicited information on how best to curb administrative tasks and streamline process, the American Medical Group Association (AMGA) and the Medical Group Management Association (MGMA) responded with several regulatory and policy reforms.
AMGA recommended CMS revise regulations and...National News
Testimony presented at CMS Stakeholder Meeting in Baltimore.
MGMA outlined the importance of the agency promulgating a regulation to establish a national standard for electronic attachments. Attachments are typically used during a practice's revenue cycle in support of claims, prior authorization, referrals, and other transactions....
