Healthcare payment policy and regulation
Payment policy and regulation encompasses the various rules, guidelines and laws governing healthcare's financial aspects, including Medicare and Medicaid reimbursement rates, medical billing, and claims administration. Payment policy and regulation also plays a critical role in shaping the healthcare landscape, affecting service accessibility and affordability.
Top Stories
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News
13 Apr 2026
CMS proposes 2.4% IPPS bump, joint replacement model expansion
A proposed rule would increase inpatient reimbursement by $1.9B next year, while expanding the Comprehensive Care for Joint Replacement Model nationwide. Continue Reading
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News
06 Apr 2026
CMS proposes Medicare payment rules for SNFs, 3 others
CMS is seeking to increase payments to skilled nursing facilities, hospices and inpatient rehabilitation and psychiatric facilities next year, while cracking down on hospice fraud. Continue Reading
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18 Jun 2019
MedPAC Suggests Elimination of Incident To Billing for APRNs, PAs
In addition to concerns about incident to billing, the commission also advised CMS to use a stay-based design for a unified post-acute care payment system and establish national ED coding guidelines. Continue Reading
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26 Jul 2018
Verma: Healthcare Payment Reform to Focus on Docs, Not Hospitals
Site-neutral payments, capitated reimbursement, and competitive bidding were among the provider-focused healthcare payment reforms suggested by CMS leader Seema Verma. Continue Reading
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News
05 Sep 2017
CMS Offers Value-Based Purchasing Exceptions After Hurricane Harvey
Providers in 32 Texas counties and five Louisiana parishes will be exempt from value-based purchasing and quality reporting requirements because of Hurricane Harvey. Continue Reading
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News
11 Aug 2015
ICD-1 to ICD-11 Timeline Highlights Healthcare’s Evolution
From ICD-9’s inception via The World Health Organization over 35 years ago to ICD-10’s kick-off this upcoming October, how far has the healthcare industry come? Continue Reading
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News
20 Feb 2015
Why Recent Attempts at Healthcare Reform Regulation Matter
Value-based care is buzzing among healthcare organizations. With new federal healthcare reform in effect, value-based care takes on new form in HHS news. Continue Reading
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News
09 Dec 2014
HIPAA Compliance within Revenue Cycle Management
The inclusion of HIPAA transactions intends to reduce administrative costs, but to do so, medical practices must strengthen their revenue cycle management. Continue Reading