News

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.

CMS recently published an FAQ to address the products, providers, and billing practices associated with drug waste modifiers -JW and -JZ.

CMS released guidance to help providers transition out of the COVID-19 public health emergency (PHE), which is expected to end on May 11.

Over three-quarters of hospitals remain noncompliant with federal price transparency regulations, according to a PatientRightsAdvocate.org report.

CMS released guidance and FAQs on the enrollment and conversion process for the newest Medicare provider type, rural emergency hospitals (REH).

The Biden administration announced its intention to extend the COVID-19 public health emergency (PHE) until May 11 and end it on that date. 

Denial rates are continuing to rise, according to a November 2022 Crowe report on revenue and expense issues in healthcare.

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.