New Study on Hospital Pricing by Houston Business Group Highlights Gaps Between Medicare and Private Insurance Payments
Employer group in Houston plans to use the numbers to pressure lawmakers for policy changes involving how hospitals and health plans price their services Clinical laboratory leaders will probably not be surprised to learn that wide disparities exist between what Medicare pays hospitals and what is paid by private insurers and employers. That’s according to […] The post New Study on Hospital Pricing by Houston Business Group Highlights Gaps Between Medicare and Private Insurance Payments appeared first on Dark Daily. (Source: Dark Daily)
Source: Dark Daily - August 3, 2022 Category: Laboratory Medicine Authors: Jillia Schlingman Tags: Coding, Billing, and Collections Laboratory News Laboratory Testing Managed Care Contracts & Payer Reimbursement anatomic pathology Baylor St. Luke’s Chris Skisak PhD clinical laboratory Dark Daily dark intelligence group Dark Report Source Type: news

CMS: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2023; Changes to the Requirements for the Director of Food and Nutrition Services and Physical Environment Requirements in Long-Term Care Facilities
Notice of final rule from the Centers for Medicare& Medicaid Services (CMS) updating the skilled nursing facility (SNF) payment rates for fiscal year 2023, the Patient Driven Payment Model (PDPM) parity adjustment, the SNF Quality Reporting Program (QRP), the SNF Value-Based Purchasing (VBP) Program, and more. Among other things, this rule establishes a permanent cap policy to smooth the impact of year-to-year changes in SNF payments related to changes in the SNF wage index and announces the application of a risk adjustment for the SNF Readmission Measure for COVID-19 beginning in FY 2023. Includes rural references thr...
Source: Federal Register updates via the Rural Assistance Center - August 3, 2022 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicare Program: Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2023; etc.
Pre-publication notice of final rule from the Centers for Medicare& Medicaid Services (CMS) updating the skilled nursing facility (SNF) payment rates for fiscal year 2023, the Patient Driven Payment Model (PDPM) parity adjustment, the SNF Quality Reporting Program (QRP), the SNF Value-Based Purchasing (VBP) Program, and more. Among other things, this rule establishes a permanent cap policy to smooth the impact of year-to-year changes in SNF payments related to changes in the SNF wage index and announces the application of a risk adjustment for the SNF Readmission Measure for COVID-19 beginning in FY 2023. This rule is effe...
Source: Federal Register updates via the Rural Assistance Center - August 1, 2022 Category: Rural Health Source Type: news

The U.S. Physician Shortage Is Only Going to Get Worse. Here Are Potential Solutions
If you’ve recently had to wait longer to see a doctor than you used to, that may not be entirely because of the COVID-19 pandemic. America is experiencing a physician shortage, and it’s only expected to get worse—a concerning situation that could lead to poorer health outcomes for many patients. Data published in 2020 by the Association of American Medical Colleges estimates that the U.S. could see a shortage of 54,100 to 139,000 physicians by 2033. That shortfall is expected to span both primary- and specialty-care fields. “The physician shortage can justly be characterized as a looming public-heal...
Source: TIME: Health - July 25, 2022 Category: Consumer Health News Authors: Elaine K. Howley Tags: Uncategorized freelance Health Care healthscienceclimate Source Type: news

Two Georgia Hospitals First to Be Fined by CMS for Failure to Comply with Hospital Price Transparency Law
Nearly two years after passage of price transparency law, only a small number of the nation’s hospitals are fully compliant, according to two separate reports Price transparency is a major trend in the US healthcare system. Yet, hospitals, physicians, clinical laboratories, and other providers have been reticent to design their websites so it is easy […] The post Two Georgia Hospitals First to Be Fined by CMS for Failure to Comply with Hospital Price Transparency Law appeared first on Dark Daily. (Source: Dark Daily)
Source: Dark Daily - July 25, 2022 Category: Laboratory Medicine Authors: Jillia Schlingman Tags: Coding, Billing, and Collections Compliance, Legal, and Malpractice Laboratory Management and Operations Laboratory News Laboratory Testing anatomic pathology Ascension clinical laboratory CMS CommonSpirit Health Dark Daily dark inte Source Type: news

Medical Billing Startup Raises $3.3M In Seed Funding As Medical Debt Increases
Medical billing advocacy startup Resolve Medical Bills announced this week it has raised $3.3 million in seed funding. (Source: Forbes.com Healthcare News)
Source: Forbes.com Healthcare News - July 22, 2022 Category: Pharmaceuticals Authors: Deb Gordon, Contributor Tags: Healthcare /healthcare Innovation /innovation Venture Capital /venture-capital Source Type: news

Viewpoint: Health plan broker payments require disclosures
The Consolidated Appropriations Act of 2021 does considerably more than ending 'surprise billing, " adding a level of transparency to health care that we ’ve never seen before. (Source: bizjournals.com Health Care:Physician Practices headlines)
Source: bizjournals.com Health Care:Physician Practices headlines - July 21, 2022 Category: American Health Authors: Jason Andrade Source Type: news

US Announces $1.2 Billion Healthcare Crackdown Tied to Telehealth, Cardiovascular Tests US Announces $1.2 Billion Healthcare Crackdown Tied to Telehealth, Cardiovascular Tests
The US Justice Department unveiled a $1.2 billion healthcare fraud crackdown on Wednesday, revealing criminal charges against 36 defendants for alleged fraudulent billing schemes.Reuters Health Information (Source: Medscape Pathology Headlines)
Source: Medscape Pathology Headlines - July 21, 2022 Category: Pathology Tags: Business of Medicine News Source Type: news

New Report Reveals That Medicare Part A Fund May Be Tapped Out By 2028, Triggering Calls for Congress to Address This Problem
Experts say it is time to change Medicare financing, even as large numbers of baby boomers continue to enroll in the program each year Medicare’s fund for payment of inpatient hospital care is expected to be tapped out in 2028. That’s according to a new report from Trustees of the Federal Hospital Insurance and Federal […] The post New Report Reveals That Medicare Part A Fund May Be Tapped Out By 2028, Triggering Calls for Congress to Address This Problem appeared first on Dark Daily. (Source: Dark Daily)
Source: Dark Daily - July 18, 2022 Category: Laboratory Medicine Authors: Jillia Schlingman Tags: Coding, Billing, and Collections Laboratory Management and Operations Laboratory News Laboratory Resources Laboratory Testing 2022 Medicare Trustees Report 4Sight Health anatomic pathology Baby Boomers CDC centers for disease control a Source Type: news

Psychiatrist Sentenced to 54 Months for Addiction Treatment Fraud Psychiatrist Sentenced to 54 Months for Addiction Treatment Fraud
Florida psychiatrist Jose Santeiro, MD, was sentenced to 54 months in jail for his role in billing $112 million worth of addiction treatment services that were never provided nor medically necessary.Medscape Medical News (Source: Medscape Medical News Headlines)
Source: Medscape Medical News Headlines - July 8, 2022 Category: Consumer Health News Tags: Psychiatry News Source Type: news

OhioHealth to cut 640 IT, billing jobs in outsourcing move
OhioHealth Corp. gave up to six months' notice on Thursday to more than 600 employees slated to lose their jobs to outsourcing. (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - July 7, 2022 Category: Biotechnology Authors: Carrie Ghose Source Type: news

Quebec tourist waited a week for emergency surgery after B.C. doctor refused to operate over billing
A Quebec man who fell and broke his jaw, cheekbone and a bone around his left eye while visiting British Columbia says his surgery was cancelled after he was told his home province "won't pay" for the procedure. (Source: CBC | Health)
Source: CBC | Health - July 7, 2022 Category: Consumer Health News Tags: News/Canada/British Columbia Source Type: news

PCPs Miss Out on Payments for Prevention, Coordination PCPs Miss Out on Payments for Prevention, Coordination
New research from the Annals of Internal Medicine suggests physicians could add $100,000 to their incomes by billing more often for preventive care and care services coordination.Medscape Medical News (Source: Medscape Business of Medicine Headlines)
Source: Medscape Business of Medicine Headlines - July 5, 2022 Category: Pharmaceuticals Tags: Internal Medicine News Source Type: news

FDA yanks MQSA certificate from imaging facility in Md.
The U.S. Food and Drug Administration (FDA) has revoked the certification unde...Read more on AuntMinnie.comRelated Reading: FDA issues guidance on appeals process for mammography facilities FDA warns of poor image quality at NY breast center FDA issues mammography alert for Md. facility FDA warns patients about NJ facility's mammograms FDA debuts online billing process for MQSA inspection fees (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - July 1, 2022 Category: Radiology Source Type: news

Some Medical Debt Is Being Removed From U.S. Credit Reports
Help is coming for many people with medical debt on their credit reports. Starting Friday, the three major U.S. credit reporting companies will stop counting paid medical debt on the reports that banks, potential landlords and others use to judge creditworthiness. The companies also will start giving people a year to resolve delinquent medical debt that has been sent to collections before reporting it — up from six months previously. Next year, the companies also will stop counting unpaid medical debt under at least $500. Read More: No Income. Major Medical Bills. What Life Is Like for Millions of Americans Facing Fi...
Source: TIME: Health - June 30, 2022 Category: Consumer Health News Authors: Tom Murphy / AP Tags: Uncategorized Health Care wire Source Type: news