National healthcare spending increased by 3.4 percent in 2021, while the Health Care Price Index (HCPI) maintained a year-over-year growth of around 2 percent, according to Altarum’s February 2022 Health Sector Economic Indicators (HSEI) briefs. Unlike the December 2021 and January 2022 briefs, Altarum included federal government expenditures in the February data, which significantly impacted […]
It’s a well-known fact that the U.S. healthcare system is the most expensive in the world. What may not commonly be as understood is that between 15 to 25 percent of total health care expenditures in the U.S. are attributable to administrative costs, and most of those costs are related to billing activities. With many […]
Honing your approach when negotiating with insurers can lead to better reimbursement rates. Last I checked my plumber charges me more than some physicians make for some services. It’s not to say that plumbers don’t work hard, but they certainly didn’t have to invest an inordinate amount of time and money to get specialized degrees. […]
There are three new codes in the care management section of the CPT codebook, covering principal care management and chronic care management services. Here’s what physicians need to know about them. Principal Care Management Services New CPT codes have been added in 2022 to describe “Principal Care Management Services.” These codes are like chronic care […]
During a National Stakeholder Call on January 18, 2022, Ellen Montz—Deputy Administrator and Director of the Center for Consumer Information and Insurance Oversight (CCIIO) at the Centers for Medicare and Medicaid Services (CMS)—announced that CMS had begun publishing state-specific letters (the “Enforcement Letters”) detailing anticipated Federal and state responsibilities with respect to enforcement of the […]
On Monday, February 7, 2022, U.S. Senators Catherine Cortez Masto, D-Nevada, and Todd Young, R-Indiana, introduced the Telehealth Extension and Evaluation Act, which if passed, would extend several of the telehealth waivers for two years after the end of the federal public health emergency (PHE). See our previous coverage of telehealth during the COVID-19 pandemic. […]
The bill comes in the wake of a U.S. Supreme Court decision blocking President Biden’s nationwide vaccine mandate for large employers. A group of California lawmakers, led by District 15 Assemblymember Buffy Wicks, have introduced a bill proposing that all businesses in the state mandate COVID-19 vaccinations for their employees. Assembly Bill 1993 would require […]
Although health plans aim to promote value-based care with prior authorization requirements, providers and patients may experience negative repercussions from the process. Prior authorization negatively impacted patients and providers alike by leading to care delays for patients and creating administrative burden for physicians, according to a survey from the American Medical Association (AMA). Health plans […]
The biggest noncompliance was non-posting or incomplete posting of all of the negotiated prices for each item and service. In a federal price transparency rule that took effect January 1, 2021, hospitals were tasked with posting all of their prices online in clear, easily accessible formats. But a new survey from patientrightsadvocate.org has found that, […]
As more providers leverage telehealth services and EHR systems, the federal government has seen increased False Claims Act violations and healthcare fraud. Healthcare digitization, including increased use of telehealth and EHR has led to a higher volume of healthcare fraud and False Claims Act (FCA) cases, according to lawyers from Hogan Lovells. The False Claims […]