The American Medical Association’s (AMA) CPT Editorial Panel recently published changes to its evaluatio and management (E/M) Services Guidelines. The update includes code revisions, additions, and deletions, which are scheduled to take effect January 1, 2023.
Roughly half of hospitals did not adhere to provisions of the Hospital Price Transparency rule that require them to post five types of standard charges for all services in a machine-readable file and a separate consumer-friendly file or price estimator for at least 300 shoppable services, according to a recent JAMA study.
The Supreme Court ruled that HHS’ failure to survey hospital costs before enacting the cuts exceed the agency’s authority under the Medicare statute, making the decision to reduce 340B reimbursement unlawful.
On June 8, CMS issued its first penalties for violations of the Hospital Price Transparency final rule to two Georgia hospitals in the same health system, Northside Hospital Atlanta and Northside Hospital Cherokee.
After a hospital gave an incorrect price estimate to a patient, the Colorado Supreme Court ruled that the patient should not have to pay the amount reflected in the hospital’s chargemaster.
The new guidance covers how payment determinations are made, what information may and may not be used, and the scope of independent dispute resolution entities’ decisions.
Among the proposed changes, many of which affect quality and data reporting programs, are proposed changes to claims data used for rate setting, a delay of the three way split criteria for MS-DRGs, and more.
The agenda for the 2022 Revenue Integrity Symposium (RIS) has been released. The event, to be held September 19–20 at the Hilton Phoenix Resort at the Peak in Phoenix, Arizona, will feature two educational tracks covering essential revenue integrity education, updates, and thought leadership.
