Tag: American Hospital Association

Prior Authorization Reform Rule Proposals

CMS Unveils Contentious Prior Authorization Reform Rule Proposals

Physicians and healthcare experts are urging Medicare to lead reforms in the time-consuming prior authorization (PA) process, which often causes delays in patient care. However, they caution against excessive reform, as it could exacerbate the problem rather than improving it. The U.S. Centers for Medicare and Medicaid Services (CMS) have put forth two proposals for […]
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Low-Reimbursement-Rates-Lead-to-Rural-Hospital-Closures

Low Reimbursement Rates Lead to Rural Hospital Closures

Low reimbursement rates, staffing shortages, low patient volumes, and regulatory barriers are some of the root causes of rural hospital closures, the American Hospital Association (AHA) explains in a new report. The report “Rural Hospital Closures Threaten Access: Solutions to Preserve Care in Local Communities” highlights the variety of causes behind rural hospital closures, which […]
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Home Health Medicare Reimbursement

Recent Updates on Home Health Medicare Reimbursement

AHA said that the 2.7 percent Medicare reimbursement update for home health agencies does not accurately reflect the financial challenges that home health agencies have faced during the pandemic. The American Hospital Association (AHA) has urged CMS to reconsider the Medicare reimbursement update for home health agencies proposed in the Calendar Year 2023 Home Health […]
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aha-requests-additional-covid-19-financial-support-from-congress

AHA Requests Additional COVID-19 Financial Support from Congress

During the Delta and Omicron surges, hospitals and health systems faced significant challenges, prompting AHA to ask Congress for additional COVID-19 financial support. The American Hospital Association (AHA) has urged Congress to provide hospitals and health systems with additional COVID-19 financial support, including more Provider Relief Funds and an extension on the Medicare sequester relief. […]
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aha-calls-for-medicare-advantage-inclusion-in-prior-authorization-rule

AHA Calls for Medicare Advantage Inclusion in Prior Authorization Rule

The American Hospital Association (AHA) has asked CMS to include Medicare Advantage organizations in its proposed rule that would streamline the prior authorization process and reduce patient care delays. In December 2020, CMS released a notice of proposed rulemaking about improving prior authorization, following past administrative and clinician struggles. If the rule is finalized, there […]
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aha-pens-oppositions-to-2022-physician-fee-schedule-proposed-rule

AHA Pens Oppositions to 2022 Physician Fee Schedule Proposed Rule

The organization is concerned about policies in the 2022 Physician Fee Schedule proposed rule, ranging from telehealth worries to apprehension about MIPS. The AHA agreed with certain aspects of the rule but also voiced various problems and recommendations for CMS to consider. The AHA opposed several telehealth policies that CMS included in the rule. The […]
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Prior-Authorization-Challenges

Prior Authorization Challenges Persist, AMA Survey Reveals

  Prior authorization still presents challenges to physicians, three years after the AMA and other health organizations released a consensus statement urging reform. A recent survey from the American Medical Association (AMA) evaluated the challenges and roadblocks of prior authorization (PA) for physicians and patients three years after a coalition of industry groups led by […]
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Surprise Billing Solution

Providers, Insurers Parse What They Could Support – And What They Won’t – In Surprise Billing Solution

While both providers and insurers have found it difficult to agree on a solution to surprise billing, experts on both sides expressed support Tuesday for banning the practice – thereby forcing insurers and providers to work out payment disputes among themselves—when patients have gone to in-network hospitals. The approach, which has been tried in Oregon, […]
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