CMS released a proposed rule on December 6 to promote transparency, efficiency, and automation in prior authorization processes. Certain requirements in the proposed rule are also intended to improve data accessibility for patients, providers, and payers.Read More »
CMS extended enforcement discretion, pending future rulemaking, for providing good faith estimates (GFE) for uninsured or self-pay patients that include price estimates from co-providers or co-facilities. The agency announced the pause in a December 2 FAQ, citing technical limitations.Read More »
CMS recently released new hospital price transparency sample formats. The formats, which come in wide, tall, and plain, may be used by hospitals to meet the requirement to make standard charges publicly available in a machine-readable file.Read More »
Revenue integrity experts, we want to hear from you. NAHRI is currently seeking speakers for the 2023 Revenue Integrity Symposium (RIS), to be held September 18–19, 2023, in Charlotte, North Carolina.Read More »
CMS is moving ahead with major changes to evaluation and management (E/M) services, telehealth, coverage of dental services, and more in the 2023 Medicare Physician Fee Schedule (MPFS) final rule. The rule, released November 1, also includes updates to vaccine payments and quality and reporting...Read More »
CMS finalized a higher-than-proposed payment increase that was almost erased for most non-drug services to offset ending reduced reimbursement for 340B drugs, according to the...Read More »
The Medical Group Management Association (MGMA) released its Annual Regulatory Burden Report on October 11. Executives from over 500 group practices said prior authorization and surprise billing requirements were the most burdensome to implement this year.Read More »
The Office of Inspector General (OIG) recently announced it will audit CMS’ monitoring and enforcement of the Hospital Price Transparency final rule. The report is expected for release in 2023.Read More »
