CMS Starts Independent Dispute Resolution Under No Surprises Act On April 15, 2022, CMS opened the Federal Independent Dispute Resolution (IDR) process for providers, facilities, and health plans and issuers to resolve payment disputes for certain out-of-network charges. After the end of a 30-business day open negotiation period, during which all parties act in good faith to...
Physician Group Asks for Updates to Federal Health Care Antitrust Enforcement In a response to a Department of Justice (DOJ) and Federal Trade Commission joint request for information on merger enforcement policy, the American Medical Association (AMA) “asked the agencies to develop a policy that protects against mergers that create or augment health insurer buyer power...
Public Health Emergency Declaration Extended On April 13, 2022, the secretary of the Department of Health and Human Services announced the extension of the Public Health Emergency (PHE) status due to COVID-19. The statement reads that that a public health emergency exists and has existed nationwide since January 27, 2020. The PHE status allows CMS...
2023 Inpatient Prospective Payment System Proposed Rule Released On April 18, 2022, CMS released a proposed rule for the Inpatient Prospective Payment System (IPPS). In addition to annual policies that promote Medicare payment accuracy and hospital stability, the fiscal year (FY) 2023 IPPS rule includes measures related to payment stability for hospitals, a policy that...