April 20, 2022
MAYA GOLDMAN
The portal to file surprise billing independent dispute resolution claims opened on Friday, but there’s a chance the process through which claims are resolved could shift in the coming months.
Federal physician malpractice database may not work as intended
April 15, 2022
LISA GILLESPIE
Hospitals appear to be skirting federal requirements to report clinician malpractice or hospital privilege revocations to a national database designed to keep patients safe.
AMA asks for delay in Provider Relief Fund clawbacks
March 31, 2022
MAYA GOLDMAN
The American Medical Association and more than 30 other medical groups want the Health Resources and Services Administration to give providers more time to report on the Provider Relief Funds dollars they received before the government takes the money back.
Feds join lawsuit against EHR vendor ModMed
March 25, 2022
MAYA GOLDMAN
The federal government will intervene in a False Claims Act lawsuit against electronic health records vendor Modernizing Medicine and its co-founders that became public Friday.
United Behavioral Health beats landmark coverage class-action
March 23, 2022
NONA TEPPER
A federal appeals court on Tuesday reversed a landmark decision that required the nation’s largest behavioral health insurer to adopt more stringent standards for mental health and substance abuse treatment and reprocess tens of thousands of claims.
OCR Cybersecurity Newsletter: Defending Against Common Cyber-Attacks
March 17, 2022
Throughout 2020 and 2021, hackers have targeted the health care industry seeking unauthorized access to valuable electronic protected health information (ePHI).
Critical-access hospitals left out of Congress’ telehealth extension
March 10, 2022
JESSIE HELLMANN
Critical-access hospitals warn that they will no longer be able to bill Medicare for telehealth services when the public health emergency ends after they were excluded from the government spending bill that the U.S. House of Representatives passed Wednesday.
CMS redesigns Direct Contracting into an ACO model
February 24, 2022
MAYA GOLDMAN
The Global and Professional Direct Contracting Model will be replaced with a more equity-focused and provider-led Accountable Care Organization Model in 2023, the Centers for Medicare and Medicaid Services said Thursday.
HHS running out of money to pay providers for treating uninsured COVID-19 patients
February 08, 2022
JESSIE HELLMANN
A federal program that reimburses healthcare providers that care for uninsured COVID-19 patients is expected to run out of money by spring or summer.
Insurers stretched provider bonuses, quality investment to avoid rebates, CMS says
February 01, 2022
Maya Goldman and Nona Tepper
A rule aimed at cracking down on how commercial insurers spend consumers’ premium dollars could upend provider compensation and accelerate adoption of value-based contracts, experts say.