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AHA Statement on FY 2024 Final IPPS & LTCH Payment Rule
The AHA is deeply concerned with CMS’ woefully inadequate inpatient and long-term care hospital payment updates. The agency continues to finalize rate increases that are not commensurate with the near decades-high inflation and increased costs for labor, equipment, drugs and supplies that hospitals across the country are experiencing.
DOL sues UnitedHealth third-party administrator for improperly denying ED claims
The Department of Labor July 31 sued a third-party administrator owned by UnitedHealth Group in the U.S. District Court for the Western District of Wisconsin, alleging it improperly denied claims for emergency services and urinary drug screening since 2015.
CMS urged not to implement proposed prior authorization attachment standard
The AHA July 27 joined AHIP, the American Medical Association, and Blue Cross Blue Shield Association in urging the Centers for Medicare & Medicaid Services not to implement its proposed HIPAA prior authorization standards for claims attachments due to conflicting regulatory proposals, which “would create the very same costly burdens” that administrative simplification seeks to alleviate.
CMS Releases FY 2024 Skilled Nursing Facility PPS Final Rule
The Centers for Medicare & Medicaid Services (CMS) July 31 issued its fiscal year (FY) 2024 final rule for the skilled nursing facility (SNF) prospective payment system (PPS).
Fact Sheet: Sen. Sanders Bill Would Reduce Funding for Patient Care, Add Burden on Health Care Providers
The AHA strongly opposes policies to decrease hospital reimbursements by eliminating “facility fees,” which are the direct and indirect costs that allow a hospital to continue to provide services to patients and serve the needs of their community.
AHA blog: What do Break-even Hospital Margins Mean for Patient Care?
“Some analyses seem to suggest that anything above a zero percent margin is inherently bad, as though the operating goal of hospitals and health systems should be to incur financial losses,” write AHA’s Bharath Krishnamurthy, director of policy and health analytics, and Benjamin Finder, director of policy research and analysis.
UnitedHealthcare identifies procedures no longer subject to prior authorization
UnitedHealthcare Aug. 1 published a list of procedures no longer subject to prior authorization effective either Sept. 1 or Nov. 1, 2023.
FTC urged to extend comment period for draft merger guidelines
The AHA Aug. 1 joined the U.S. Chamber of Commerce and other organizations in urging the Federal Trade Commission to extend for at least 60 days the comment period for their draft guidance revising how they review mergers and acquisitions to determine compliance with federal antitrust laws.
FTC Urged to Extend Comment Period for Draft Merger Guidelines
The AHA joins the U.S. Chamber of Commerce and other organizations in urging the Federal Trade Commission to extend for at least 60 days the comment period for their draft guidance revising how they review mergers and acquisitions to determine compliance with federal antitrust laws.