Money received through the Provider Relief Fund could be at risk as audits ramp up
Recipients of Provider Relief Fund (PRF) distributions and COVID-19 Uninsured Program payments should be girding themselves for audits, legal experts say. The programs represent “a two-front audit fight that providers are facing and will face in the coming years,” Brian Lee, partner with Alston & Bird, said during an Aug. 24 webinar hosted by the…
Healthcare News of Note: 54% of patients do not care whether they see a corporate or independent primary care provider, but more prefer independent practices, survey says
Over the past few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals. 1. 38% of survey respondents prefer seeing an independent practice provider while 8% prefer corporate providers Although more than half of patients (54%) “have no preference between an independently owned or a corporate medical…
The evolution of telehealth and the potential for sustainability
The surge in use of telehealth services seen during the pandemic has slowed, but telehealth remains a key modality amid policy changes that will help set the course for the future of virtual care. “There’s no alternative,” said Kyle Zebley, senior vice president for public policy with the American Telemedicine Association (ATA) and executive director…
Summary: 10 vital responses to healthcare disruption
Note: This article is a summary of a report on HFMA’s Spring Thought Leadership Retreat. The full report is available to download. Disruption is reverberating throughout the healthcare industry, and it’s incumbent on legacy organizations to develop strategic responses for the benefit of their consumers, their communities and themselves. With that overarching challenge becoming ever…
News Briefs: Hospitals foresee adverse impacts from the FY24 inpatient payment rule
The FY24 final rule for Medicare inpatient payments didn’t bring hospitals the type of rate update they had sought, and for some organizations, a bigger concern is changes to uncompensated care (UC) payments. The regulations, which take effect Oct. 1, establish a 3.1% increase in operating payment rates, on average, for hospitals that meet quality-reporting…
Prices of drugs for diabetes, heart failure and more will be up for negotiation in Medicare next year
The U.S. Department of Health and Human Services (HHS) on Tuesday announced the first 10 Medicare Part D drugs that will be subject to price negotiations, the headlining healthcare-related provision of the Inflation Reduction Act. Signed in August 2022, the law gave Medicare authority to negotiate with drug manufacturers over the prices of selected drugs.…
Heffernan and Stoll honored with 2023 Morgan Awards
HFMA’s highest individual award — the Frederick C. Morgan Award for Individual Achievement — is awarded annually to a member who has made outstanding contributions to the Association over the course of a career. For only the third time since the award was first presented in 1959, two members received the special honor when the…
Healthcare News of Note: Latino, Black and Asian people ‘significantly more likely’ to enroll in Medicare Advantage
Among beneficiaries of color, Medicare Advantage enrollees are demographically and geographically different from those in fee-for-service Medicare. Turnover among hospital CEOs has trended downward since hitting 20% in 2013. Eleven of the 100 U.S. hospitals to earn NRC Health’s Consumer Loyalty Award were also honored with the organization’s Consumer Loyalty “Best in Class” Award for…
No Surprises Act litigation update: QPA methodology deemed illegal as Texas Medical Association wins in court again (updated)
Note: The first section of this article has been updated with the latest news on the status of the arbitration portal. The fourth victory in four cases brought by the Texas Medical Association (TMA) has implications for how insurers calculate the qualifying payment amount (QPA) used to arbitrate out-of-network payment sums under the No Surprises…
Data indicate hospital operational logjams haven’t ceased after the public health emergency (updated)
Note: The fourth section of this article has been updated with news of proposed mandatory staffing ratios for long-term care facilities. Some of the problems that strained hospital operations during the peak of the COVID-19 pandemic have eased, but not enough to mark a true industrywide recovery, a recently released report suggests. Notably, the process…