The payer will expand its partnership with Allina Health to cover more members under Medicare Advantage value-based contracts. “This value-based agreement for Humana Medicare Advantage members is an important part of helping our members achieve their best health,” Chuck Dow, vice president and Medicare regional president for Minnesota at Humana. “We’re excited to share with […]
Three new diagnosis codes for reporting COVID-19 vaccination status will go into effect April 1, 2022. The codes were presented by the National Center for Health Statistics (NCHS) at the Sept. 14-15, ICD-10 Coordination and Maintenance Committee meeting, so they are not listed in the 2022 ICD-10-CM code book. The new ICD-10-CM codes for reporting […]
Hospitals across the nation are seeing lower profits, and it’s all because of a sudden tsunami of Medicare and Medicaid provider audits. Whether it be by Recovery Audit Contractor (RACs), Medicare Administrative Contractors (MACs), Unified Program Integrity Contractors (UPICs), or otherwise, hospital audits are rampant. Billing errors, especially “supposed bundling,” are causing a high rate […]
The number of improper payments made under Medicare fee-for-service declined by $20.72 billion since 2014, according to new figures from the Biden administration. “The continued reduction in Medicare fee-for-service improper payments represents considerable progress toward the Biden-Harris Administration’s goal of protecting CMS programs’ sustainability for future generations. We intend to build on this success […]
CMS attributes the increases in part to rising prices and utilization across the healthcare system, as well as Aduhelm. The standard monthly premium for Medicare Part B enrollees will be $170.10 for 2022, an increase of $21.60 from $148.50 in 2021. This represents a 14.5% increase. The annual deductible for all Medicare Part B beneficiaries […]
The survey found that median provider salary and benefits expense as a percent of net revenue increased from 72.1 percent to 84.9 percent, which is the outcome of provider compensation being protected during the COVID-19 pandemic combined with decreased productivity. In addition, the survey showed a net revenue decrease from 24.2 percent to 22.8 percent […]
Patient financial assistance with hospital bills was sought out at a higher rate in 2021 compared to 2020 partly due to hospital billing practices, according to new data from TransUnion Healthcare. Patients may receive financial assistance from hospitals to help them understand all the options available to them when it comes to paying their medical […]
The Centers for Medicare & Medicaid Services (CMS) has finalized 2022 payments and policies under the Medicare Physician Fee Schedule (MPFS). The rule includes updates to payment rates for physicians and other healthcare professionals for calendar year (CY) 2022; expands the use of telehealth for mental health; clarifies policies related to split (shared) visits, critical […]
The pandemic has changed patients’ use and perceptions of healthcare organizations. The question remains: Will those changes here to stay? PATIENTS PREFER TELEHEALTH SERVICES FROM DOCTORS, HEALTH PLANS Most telehealth users accessed virtual care services through their regular doctor or health plan as opposed to direct-to-consumer telehealth platforms, according to new data from Morning […]
More than a third of Representatives call on the federal government to revise No Surprises Act implementation, specifically around the independent dispute resolution process. A bipartisan group of 152 House members wrote to the secretaries of Health and Human Services, Treasury and Labor and urged them to amend the interim final rule (IFR) that will […]