The first thing you should know about HIPAA is that it’s HIPAA, not HIPPA, as is commonly seen. There is only one “P,” and that “P” doesn’t stand for “privacy.” If you have heard the acronym “HIPAA” (referring to the Health Insurance Portability and Accountability Act of 1996) thrown around a lot lately, you may […]
On July 1, the Department of Health and Human Services (HHS), Department of Labor, and Department of the Treasury (Departments) jointly issued interim final rules (IFR) implementing certain aspects of the No Surprises Act (Act), which was signed into law on December 27, 2020, as part of the Consolidated Appropriations Act, 2021. The purpose of […]
Surprise billing compliance will have impacts throughout the revenue cycle, so preparation now is key to meeting the January 1st deadline. A prohibition on surprise billing is coming at the start of next year and federal agencies have started to release what surprise billing compliance will look like. These new compliance requirements will have a […]
Dive Brief: In a win for providers, CMS dropped a requirement that would have forced hospitals to disclose their contract terms with Medicare Advantage plans from its final inpatient pay rule for 2022 released Monday. The rule bumps payment for inpatient services by 2.5%, which will result in hospitals getting $2.3 billion more than this […]
A new executive order is putting consolidation in healthcare in the spotlight; industry experts share what policy and regulation will mean for provider merger and acquisition activity. Healthcare mergers and acquisitions have promised to bring lower costs, higher quality, and better access to care. But a new executive order is challenging the rapid pace […]
New legislation aims to eliminate the cost-sharing requirement for Medicare beneficiaries to get chronic care management services and reimburse providers for 100% of the payment. The legislation, reintroduced Thursday, intends to boost access among seniors to chronic care management services that include creating a care plan and medication reconciliation and adherence. “Chronic health conditions […]
Outside financial aid might not be the best long-term solution to the national problem of high healthcare costs and inadequate insurance coverage, but two rural hospitals are taking innovative approaches to tapping philanthropic resources to reduce their bad debt and help patients with medical bills. The American Hospital Association’s latest Annual Survey of Hospitals showed […]
Released earlier than usual, the fiscal year (FY) 2022 ICD-10-CM Official Guidelines for Coding and Reporting became available online Monday, July 12, and include instructions for assigning novel code U09.9 Post COVID-19 condition (found under Section I.C.1.g.1). Familiarize yourself with the following new and revised guidance, effective October 1, to ensure proper diagnosis coding and […]
Medical practices are leaving money on the table by under-coding. Are one or more of your physicians under-coding? Missing revenue? Or relying too much on COVID-related funding? These are valid questions, as medical practices are getting back to pre-pandemic levels of care and encounters. Under-coding in particular has been a topic of concern lately. As […]
Hospital groups are digesting the 863-page CY 2022 OPPS proposed rule, but many are already commenting on new hospital price transparency penalties and other policies. The newly proposed Medicare Outpatient Prospective Payment System (OPPS) rule for calendar year (CY) 2022 is causing a stir with new hospital price transparency enforcement rules and other policies. The […]