The patient financial experience and No Surprises Act are top of mind for revenue cycle leaders as we move into 2023. As hospitals try to navigate the COVID-19 crisis, inflation, labor shortages, and rising expenses, organizations are going to...
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Regulatory burden is on the rise yet again as practices struggle with prior authorizations, No Surprises Act compliance, and the Quality Payment Program, MGMA reports. Prior authorizations are still the top regulatory burden according to...
More InfoProvider charges for out-of-network care increased by $1,157 after the passage of state surprise billing laws that allow arbitrators to consider provider charges in a surprise billing dispute. State surprise billing laws that allow arbitrators to...
More InfoThe final surprise billing rules downgrade the weight the QPA has on out-of-network payment determinations and establishes documentation requirements for down coding situations. The Biden Administration has released final surprise billing rules...
More InfoTwenty percent of adults said they or a family member has received a surprise medical bill since the No Surprises Act went into effect on Jan. 1 according to a Morning Consultant report released July 7. Morning Consultant conducted a survey among...
More InfoThe organization recommended CMS update the independent dispute resolution portal to improve communication between disputing parties and adjust the form field requirements. The Medical Group Management Association (MGMA) has asked CMS to update...
More InfoThe No Surprises Act went into effect in December 2021 and may have prevented millions of surprise billing claims in its first two months. May 24, 2022 – Since the No Surprises Act went into effect, the law has prevented more than two...
More InfoAfter appealing the courts’ ruling on vacating a piece of arbitration within the No Surprises Act, HHS asks the court for a hold on its plea. HHS recently requested for a hold on its appeal of a Texas federal court ruling vacating parts of...
More InfoCMS recently released new data on hospital changes of ownership, a health equity plan and said it would end a legal battle with Texas over Medicaid. Becker’s has reported on the following 13 CMS moves since April 8. Finance No hospitals...
More InfoThe act seeks to reduce surprise billing through independent dispute resolution and incentives for providers to join health plan networks. The No Surprises Act used a couple of methods to reduce surprise billing, though the need for some...
More InfoDuring 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...
More InfoOn July 1, the Department of Health and Human Services (HHS), Department of Labor, and Department of the Treasury (Departments) jointly issued interim final rules (IFR) implementing certain aspects of the No Surprises Act (Act), which was signed...
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