Medicare could have saved over $200 million in payments for definitive drug testing services between 2016 and 2020 if proper program safeguards had been in place, according to a recent audit report by the Office of Inspector General (OIG).
Providers are more frequently billing for outpatient evaluation and management services with high-level codes, which has led to higher outpatient spending, according to a recent study.
HHS released a policy roadmap for providers ahead of the public health emergency (PHE) conclusion. The roadmap details policies that will simultaneously end with the PHE, as well as flexibilities that have been extended for various time periods.
A federal judge remanded remedy decisions to HHS for its underpayments related to the 340B drug pricing program. After experiencing several key wins throughout their long legal battle with HHS, the American Hospital Association and other industry plaintiffs were disappointed by the ruling.