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.
Automation and similar technologies are increasingly prevalent in revenue integrity but understanding best practices and long-term implications is still a major challenge. Learn how one organization is tackling misconceptions to make breakthroughs in deploying automation.
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.
A federal judge ruled in favor of the American Hospital Association (AHA) and other industry plaintiffs on September 28, ordering HHS to stop its reimbursement cuts to the 340B Drug Pricing Program for the remainder of the year.
HHS recently released final rules for implementing components of the No Surprises Act. These rules expand upon several provisions of the July 2021 and October 2021 interim final rules regarding the qualified payment amount and the federal independent dispute resolution process.
In the 2022 NAHRI Leadership Council survey: Custom Edits—Creation and Workflow, 100 leaders, including revenue integrity, health information management (HIM), and coding directors and managers primarily from acute care hospitals and health systems with 500+ beds shared key insights into their custom edit processes, including workflow locations, oversight hierarchy, and the leading factors that drive custom edits.