Medicaid Payment and Reimbursement

Healthcare provisions in massive legislation could improve care access but also reduce federal funding for some hospitals

In pending legislation, reductions to disproportionate share hospital payments would be used to subsidize commercial insurance for low-income residents of states that haven’t expanded Medicaid.

By Nick Hut November 24, 2021

Healthcare News of Note: Medicare would save $8 billion a year if all hospitals achieved the outcomes of the most cost-efficient performers, says Lown Institute

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: America’s most cost-effective hospitals are identified, employers have boosted telemedicine and mental health benefits during the pandemic, and risk-based Medicare Advantage models gain popularity with health systems.

By Deborah Filipek November 19, 2021

CMS finalizes vaccination requirements for hospitals and most other healthcare settings

If hospital staff aren’t fully vaccinated by Jan. 4, their organization will be deemed noncompliant with Medicare and Medicaid regulations, according to a new rule handed down Thursday by CMS.

By Nick Hut November 13, 2021

Healthcare News of Note: Patients in the U.S. shouldered more than $21B in cancer care costs in 2019

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: U.S. patient cancer care costs totaled $21.09 billion in 2019, healthcare safety scores fell amid the pandemic, and states are leveraging MCO contracts to improve community SDOH.

By Deborah Filipek November 8, 2021

The Provider Relief Fund distribution formula may have left some higher-need hospitals at a disadvantage, study finds

Critical access hospitals generally received lower allocations from a targeted distribution pool compared with hospitals that had a better asset mix.

By Nick Hut October 28, 2021

Hospital groups express concern over earlier court ruling that could expand False Claims Act liability

The groups argue that allowing FCA claims to be brought for post-termination actions would defy congressional intent and leave hospitals subject to excessive financial liability.

By Nick Hut October 19, 2021

After a long wait, HHS sends out details on the next Provider Relief Fund distributions

The U.S. Department of Health and Human Services announced $25.5 billion in upcoming distributions from the Provider Relief Fund.

By Nick Hut September 28, 2021

Recipients of COVID-19 vaccine boosters won’t have to pay anything out of pocket, CMS confirms

Medicare beneficiaries will owe nothing out of pocket for receiving an authorized booster dose, and the same applies to almost all Medicaid beneficiaries and most commercial health plan members.

By Nick Hut September 26, 2021

COVID-19 vaccination of staff now a condition of participation in Medicare and Medicaid, CMS announces

In a major expansion of COVID-19 vaccine requirements, the Biden administration announced Sept. 9 that all staff working at Medicare- and Medicaid-certified facilities must receive the vaccine.

By Nick Hut September 9, 2021

Healthcare News of Note: Providers should continue forward movement on improving digital patient access, survey suggests

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Expectations for convenient access to care in the pandemic era, a look at ICU bed use across the U.S., and the cost of hospitalizations among unvaccinated adults.

By Deborah Filipek September 3, 2021
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