Dec 22, 2020 | Legislation/ Budgets/ Macro, Medicaid, Medicare
HHS OIG and CMS have finalized reforms to the Stark Laws, Anti-Kickback Act, and Beneficiary Inducement rules to facilitate the growth of value-based care arrangements that rely on greater cooperation between providers and incentives for beneficiary behavior. Click to read more.
Dec 21, 2020 | Legislation/ Budgets/ Macro
An Out-of-Network (OON) Surprise Billing compromise announced recently is based entirely on dispute resolution, without using benchmarks, and has been enacted in the end-of-year COVID relief package. Click to read more.
Dec 18, 2020 | Managed Care Friday
49: The percent of Medicaid, Medicare, and commercial payers who named this their top priority for 2021 in what is a bit of surprise but an indication of how the health system continues to evolve. The new #1, the full Top 20 priorities and what moved up and moved out since last year will be reported in the 15th edition of the Healthcare Payer Index coming out soon. Stay tuned. Alternative Pay: 31% of surveyed payers say they are thinking about the next generation of payment models and one model, likely developed by some insurers, will target severely mentally ill populations. But creating...
Dec 17, 2020 | Physician Fee Schedule
CMS has finalized 2021 updates to the physician fee schedule. This brief summarizes key provisions in the rule, which were mostly finalized as proposed. Click to read more.
