Reimbursement
AHA comments in response to the Centers for Medicare & Medicaid Services’ Request for Information regarding the Medicare Advantage program.
Anthem, the country’s second-biggest health insurance company, is behind on billions of dollars in payments owed to hospitals and doctors because of onerous new reimbursement rules, computer problems and mishandled claims, says a Kaiser Health News article that is spotlighted in USA Today.
The mission of each and every hospital in America is to serve the health care needs of the people in its community 24 hours a day, seven days a week. But, hospitals’ work is made more difficult by our fragmented health care system — a system that leaves millions of people unable to afford the…
This video includes an AHA Virtual Advocacy Day presentation on legislation to secure the extension of the Medicare sequestration moratorium set to expire on April 1, 2021.
A complicated set of factors involving governmental and private-sector spending on health care will bring about significant changes over the next several years that will effectively flatten reimbursement levels, even as demand for services is expected to keep growing. While that’s generally bad…
The Centers for Medicare & Medicaid Services Dec. 2 issued its calendar year (CY) 2021 outpatient prospective payment system (OPPS)/ambulatory surgical center (ASC) final rule. In addition to standard updates, the rule maintains previous payment cuts for certain drugs purchased under the 340B…
Summary of CMS’ CY 2021 Medicare physician fee schedule final rule
The Centers for Medicare & Medicaid Services (CMS) Nov. 20 released an interim final rule implementing the Most Favored Nation (MFN) Model, a new payment model through the Center for Medicare and Medicaid Innovation (CMMI) that will cut Medicare Part B payments for certain drugs to the lowest…
Responding to the Centers for Medicare & Medicaid Services’ physician fee schedule proposed rule for calendar year 2021, the AHA said it appreciates the agency’s effort to continue certain pandemic-era policies that have helped hospitals and health systems ensure access to care for patients…
It is unfortunate that RAND continues to make broad claims about pricing based on a cherry-picked and limited data set.