Compliance

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.

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.

Reach your destination by planning for revenue integrity success.

Consider the financial impact of CMS’ proposals for outpatient hospital payments.

Review CMS’ proposals in the 2023 Medicare Physician Fee Schedule for changes to facility E/M coding and other coverage and reimbursement updates.

Ensure your organization is complying with CMS’ latest requirements for hospital inpatient billing and reimbursement.

CMS only collected approximately half of the $498 million in Medicare overpayments identified by the Office of Inspector General (OIG) for services between October 1, 2014, and December 31, 2016, according to an audit report published in July.

Federal price transparency regulations are forging ahead with the help of state-level reinforcements like Colorado’s HB 22-1285. The act prohibits a hospital from collecting a patient’s debt if their charges were acquired on a date when the hospital was noncompliant with the CMS price transparency requirements.