March 17, 2022
Throughout 2020 and 2021, hackers have targeted the health care industry seeking unauthorized access to valuable electronic protected health information (ePHI).
Category: News
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.
Give Medicare direct contracting time to prove its value or expose its flaws
January 26, 2022
Dr. Clive Fields and Gary Jacobs
Healthcare experts have argued for years that we should move away from the dysfunctional, unsustainable fee-for-service Medicare reimbursement system and toward value-based models that incentivize better health outcomes such as reduced hospitalizations and post-acute care costs.
CMS vaccine policy now enforceable in all 50 states
January 19, 2022
MAYA GOLDMAN
The federal COVID-19 vaccine mandate for healthcare workers can officially go into effect nationwide after a judge tossed out a challenge to the mandate from Texas on Wednesday.
Supreme Court allows healthcare worker vaccine mandate to continue
January 13, 2022
MAYA GOLDMAN
The Supreme Court ruled Thursday that the federal government’s COVID-19 vaccine mandate for healthcare workers can continue while appeals are pending at lower courts.
Medicare Advantage market shows signs of valuation bubble ready to burst
January 04, 2022
NONA TEPPER
TARA BANNOW
The past several years have seen headline after headline about investors buying up Medicare Advantage-focused providers for huge sums of money and throwing cash behind startup insurers that promise to disrupt the $350 billion market.
Lenox Hill surgeons sue UnitedHealth, Aetna over reimbursements
December 22, 2021
MARI DEVEREAUX
UnitedHealth Group and CVS Health’s Aetna have been hit with a trio of lawsuits alleging the insurance companies failed to properly reimburse surgeons.