Congressional hearings on the Change Healthcare cyberattack bring attention to providers’ continuing predicament
Two congressional hearings involving the CEO of UnitedHealth Group offered few concrete solutions to the issues surrounding the Change Healthcare cyberattack but did highlight the ongoing pressures facing healthcare stakeholders. Andrew Witty, the CEO, was questioned May 1 by the Senate Finance Committee in the morning and a House subcommittee in the afternoon. For providers…
Demonstrating revenue cycle excellence just got easier with the newest HFMA certification
The Executive of Healthcare Revenue Cycle (EHRC) certification, HFMA’s newest member recognition, has been quite popular with members since it was announced in mid-February. As of March 31, 22 HFMA members had applied for the EHRC certification and 18 members earned it, demonstrating excellence in revenue cycle, said Shirley Heavlin, certification operations manager for HFMA.…
Seeking to improve healthcare for Medicaid beneficiaries, CMS issues a flurry of regulations
CMS over the last month published a trio of final rules intended to make the Medicaid program work better for beneficiaries, with implications for healthcare providers. The three rules address eligibility and enrollment, access and Medicaid managed care. Streamlining eligibility and enrollment The first rule addresses administrative barriers in an effort to simplify enrollment processes…
FTC challenge adds to the strain on the hospital-based anesthesiology workforce
A Federal Trade Commission (FTC) challenge to the purchase of a major anesthesia provider, after a rocky couple of years for anesthesia providers, has created an even murkier outlook for hospital-based anesthesia services. The FTC’s suit, filed in September against U.S. Anesthesia Partners, Inc. (USAP) and the private equity firm Welsh, Carson, Anderson & Stowe,…
A new 340B dispute resolution process could create more opportunities for providers
Regulatory updates to the administrative dispute resolution (ADR) process in the 340B Drug Pricing Program seem likely to expedite the filing of claims over manufacturers’ refusal to offer discounts on drugs distributed at contract pharmacies. HHS and the Health Resources and Services Administration (HRSA), which administers the 340B program, published a final rule that modifies…
The FTC’s new non-compete regulations will affect hospital agreements with physicians, unless courts intervene
Hospital advocates expressed concern about the implications of new federal regulations that prohibit employers from including non-compete clauses in employment agreements. Although tax-exempt hospitals largely fall outside the jurisdiction of the Federal Trade Commission (FTC), which will enforce the regulations, the newly issued final rule stands to affect clinical staffing. Non-compete agreements apply to between…
How a health system goes above and beyond in its price transparency efforts
By maintaining a patient-centric perspective, hospitals and health systems can find opportunities to look beyond regulatory requirements and incorporate top-class price transparency models, according to a recent online discussion. “We want to, first and foremost, empower and equip our customers to make informed decisions about their healthcare services and really shop for the best value,”…
CMS calls for hospitals to be subject to a new bundled payment model and data-reporting requirements
Notable policies in Medicare’s FY25 proposed rule for inpatient hospital care and long-term care hospitals include the formation of a mandatory bundled payment model and requirements for hospital data reporting. Although the proposed payment rate was the headlining aspect of the rule for hospitals, the policy developments could have a longer-term impact on segments of…
Honor Roll: HFMA certifications were awarded to 1,904 members Jan. 1 – March 31, 2024
As of Q1 2024, HFMA offers nine certifications for members to validate their expertise and demonstrate their commitment to the profession, including the newest certification: the Executive of Healthcare Revenue Cycle (EHRC). The HFMA certifications are as follows: Certified Healthcare Financial Professional (CHFP), Certified Revenue Cycle Representative (CRCR), Certified Revenue Cycle Representative (CRCR) – GCC,…
The Medicaid unwinding continues to pose issues one year in, but healthcare coverage appears stable
The unwinding of Medicaid continuous-enrollment requirements reached the one-year mark this month amid mixed measures of the effect on overall coverage. In one sense, the impact has exceeded all projections. Since states could begin disenrolling Medicaid beneficiaries on April 1, 2023, coverage for more than 19.6 million beneficiaries had been terminated as of April 4,…