Compliance
This section focuses on health care compliance and regulations – both national and state – including the ACA. It includes changes in health care law, regulation, and court decisions and their impact on health insurance professionals, employers, and individuals.
Dive Brief: * The long-term shift from hospital-based care toward more treatment delivered in the home and ambulatory centers picked up pace during the COVID-19 pandemic and is expected to continue to gain momentum, pressuring revenue growth and margins in the hospital sector, according to new research from Moody’s Investors Service. * Reimbursement changes, risk-sharing, investment ...
The Department of Health and Human Services (HHS) is examining risk adjustment tactics that have led to overpayments to some Medicare Advantage plans, Secretary Xavier Becerra told reporters Friday. Becerra said the agency has seen evidence of charges going beyond what would be necessary for MA plans using tactics such as up-coding. The remarks come ...
During HIMSS22, Philips gave its top predictions for the future of healthcare systems over the next three years based on labor market trends and the expansion of hospital-at-home services. Roy Jakobs, chief business leader of Connected Care at Philips, offered the following predictions: * Over the next three years, 40% of providers will shift 20% of ...
A Senate committee has approved a bipartisan blueprint to overhaul the nation's public health system, applying the lessons of COVID-19 to future outbreaks through a new chain of command, a stronger medical supply chain, and clearer crisis communications.
Patients are no longer required to pay for out-of-network care given without their consent when they receive treatment at hospitals covered by their health insurance since a federal law took effect at the start of this year. But the law’s protections against the infuriating, expensive scourge of surprise medical bills may be only as good ...
The Southern Nevada Health District is looking into a data discrepancy that shows Clark County in the Centers for Disease Control and Prevention’s “high” transmission tier, a health official said Wednesday. CDC data showed the county in the highest transmission tier on Tuesday because it had a case rate over 100 per 100,000 people. Cassius ...
Dive Brief: * An online tool that allows patients in markets across the country to compare prices for hundreds of hospital services before getting treatment has launched in its beta development stage. * Turquoise Health’s platform uses cost data from machine-readable files made public by hospitals as part of compliance with a federal price transparency rule that ...
The extension would leave the flexibilities in place for 151 days after the end of the federal public health emergency, which currently expires in April but is expected to be extended into July.
Top executives at two of the biggest Covid-19 vaccine manufacturers are split over how necessary a fourth dose is for most of the world’s population. Pfizer Inc. Chief Executive Officer Albert Bourla said in a CBS interview on Sunday that protection from three shots will wane and a fourth dose is needed “right now”. Then, ...
Last spring, Lags Medical Centers, a sprawling chain of pain clinics serving more than 20,000 patients in California, abruptly shuttered amid a cloaked state investigation into “credible allegations of fraud.” Tens of thousands of patients were left scrambling for care, most of them low-income Californians covered by state and federal insurance programs. Many have struggled ...