New & Notable
CMS proposes expanded authority to revoke Medicare privileges
CMS proposes expanding its authority to revoke Medicare providers in fraud crackdown, while updating home health payments with a 2.4% increase and continued PDGM adjustments.
CMS takes aim at 340B, site-neural payments in OPPS proposal
The proposed Hospital Outpatient Prospective Payment System rule also includes a 2.4% rate boost, prior authorization for Botox injections and a more aggressive 340B remedy plan.
Elevance: No Surprises Act IDR awards hit 'extreme' levels for OR
Providers are winning 90% of payment disputes for planned procedures with awards up to 119 times typical rates, raising questions about the No Surprises Act's impact.
Provider compensation grew, but productivity outpaced pay
New data from AMGA shows a 4.3% bump in provider compensation last year, driven by productivity growth rather than reimbursement increases.
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Latest News
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CMS proposes expanded authority to revoke Medicare privileges
CMS proposes expanding its authority to revoke Medicare providers in fraud crackdown, while updating home health payments with a 2.4% increase and continued PDGM adjustments.
-
CMS takes aim at 340B, site-neural payments in OPPS proposal
The proposed Hospital Outpatient Prospective Payment System rule also includes a 2.4% rate boost, prior authorization for Botox injections and a more aggressive 340B remedy plan.
-
Elevance: No Surprises Act IDR awards hit 'extreme' levels for OR
Providers are winning 90% of payment disputes for planned procedures with awards up to 119 times typical rates, raising questions about the No Surprises Act's impact.
-
Provider compensation grew, but productivity outpaced pay
New data from AMGA shows a 4.3% bump in provider compensation last year, driven by productivity growth rather than reimbursement increases.
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How the U.S. spent $5.7T on healthcare
A new analysis from federal actuaries shows another year of U.S. healthcare spending growth over 7%, but legislative reform will temper healthcare's acceleration, they say.
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Revenue cycle AI, IDR disputes drive 9% medical cost trend
The medical cost trend is reaching its highest level in nearly two decades as AI-enabled coding and provider wins under the IDR process inflate costs, PwC says.
Features
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Amid staffing shortages, AI becomes medical coding's backup hire
Even competitive providers like UC Davis Health now use AI to support thinning medical coding teams, creating more tech-driven workflows and a fundamental shift in the workforce.
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New No Surprises Act rules won't fix $51M crisis, TX group says
Radiology Associates of North Texas expects to pay millions to participate in the No Surprises Act's IDR process even as CMS tries to alleviate major pain points for providers.
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The U.S. finally bent the healthcare cost curve, one economist says
Health economist David Cutler's new analysis shows a deceleration in U.S. healthcare spending as technology advancements make care cheaper.
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How AI scribes are shifting coding intensity, reimbursement
The proliferation of AI scribes for clinical documentation has started a shift in coding intensity, raising concerns about reimbursement and affordability.