Tagged with Multi-Specialty

Texas to Receive Increase in Federal Funds for Uncompensated Care

The Texas Health and Human Services Commission announced, on October 1, that the state will be given $11.6 billion over the next three years to help reimburse health care providers for indigent services and is intended to benefit hospitals, clinics, public ambulance, and dental providers.

Proposed Legislation Aims to Improve Provider Directories Accuracy

Two physician lawmakers have proposed new legislation that aims to improve the accuracy of information in health plan provider directories and protect patients from surprise out-of-network bills. The Improving Provider Directories Act (HR 4575) would require health plans to provide an avenue for people to report errors in provider directories, in a “highly visible way”.

Executive Order Issued to Protect Traditional Medicare and MA Plans

The president, on October 3, signed an executive order directing the Department of Health and Human Services to increase efforts to provide more insurance plan options under Medicare Advantage and to remove regulations that are considered burdensome to health care providers. The order is intended to protect traditional Medicare and private Medicare Advantage while ramping up alternative payment models, time spent with patients, access to innovative technology and reducing the regulatory burdens on providers.

House Approves CR, Senate Unveils Draft HHS Bill

The House, on September 19, approved a short-term spending measure that will keep the government funded through mid-November and avoid a shutdown at the beginning of October. Additionally, the Senate, on the 18th, released the FY2020 subcommittee chairman’s recommendation for the Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) Appropriations bill.

Improper Payment for Intensity-Modulated Radiation Therapy Planning Services

In a recent report, the Office of Inspector General (OIG) determined that payments for outpatient Intensity Modulated Radiation Therapy (IMRT) did not comply with Medicare billing requirements. Specifically, hospitals billed separately for complex stimulations when they were performed as part of IMRT planning. Overpayments occurred because hospitals are unfamiliar with or misinterpreted CMS guidance.

Anthem Connecticut Introduces New Prior Auth Pass Program

Anthem is introducing a new program to reduce the administrative burden associated with current prior authorization (PA) processes for providers who are contracted with Anthem in Connecticut. The Prior Auth Pass Program allows providers who meet program requirements to waive prior authorization for select outpatient medical procedures that generally have high rates of PA requests and approvals.

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