On Wednesday, February 23, 2022, a federal court in Texas struck down five controversial portions of the interim final rule (“Rule”) jointly issued by three federal executive agencies (“Departments”) that implement the independent dispute resolution (“IDR”) process of the No Surprises Act (“NSA”). The portions of the Rule at issue set forth certain parameters […]
In December 2021, the Centers for Medicare & Medicaid Services (CMS) released the proposed Notice of Benefit and Payment Parameters for 2023. This proposal kicks off the annual rulemaking cycle for the Marketplaces and the individual and group health insurance markets for plan year 2023 and beyond. This year’s notice is the first to […]
The Health Resources and Services Administration (HRSA) has paid over 5 million claims for COVID-19 vaccinations of uninsured Americans, according to a recent announcement. The claims were paid through the HRSA COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured, a program funded by pandemic-related legislation […]
A lobbying onslaught from the health care industry nearly stopped Congress from passing a nationwide ban on “surprise” medical bills last year. Now, the same powerful groups are racing to sway federal agencies tasked with making the new law work — with billions of dollars and promised patient protections on the line. Health groups and […]
Clinicians who served more patients with social risk factors such as low income performed worse in the Merit-Based Incentive Payment System’s inaugural payment year, and therefore, received unfavorable value-based reimbursement, according to a new study. The study recently published in Health Affairs found that out of 510,020 clinicians participating in the Merit-Based Incentive Payment System (MIPS) in […]