Policy and Legislation
With Medicare's "two midnight rule" set to take effect later this year and audit appeals facing lengthy backlogs, the Recovery Audit Contractor program may be headed in some new directions.
Emergency rooms across the country need to prepare themselves for an increase in ER visits as more uninsured people gain insurance under healthcare reform.
An unusual 90-day grace period for government-subsidized health plans may leave physicians at risk for not getting paid for their services.
The financial impact of the two midnights rule remains an open question and so is whether recovery auditors will challenge fewer claims or just shift their focus.
Even as the Affordable Care Act is in its nascent stages, some states are already looking toward 2017 when they can request waivers to opt out of the healthcare exchanges. And a small, but persistent, movement has popped up toward a single payer system as an alternative to participating in the exchanges.
With several states weighing whether to expand Medicaid under the federal health law, supporters are looking to powerful business groups to help sway skeptical state legislators. But those groups are split on the issue -- just like the public at large.
Despite the hassle of auto-cancellations, many home healthcare agencies find it difficult to keep track of their requests for anticipated payment.
A new federal regulatory proposal to ensure adequate insurance networks could help not-for-profit hospitals, Moody's said in a briefing released this week.
The number of people determined eligible for Medicaid since the launch of new insurance marketplaces is approaching 10 million, according to new data released from the Centers for Medicare & Medicaid Services.
The recent delay of the employer mandate for medium-sized businesses will harm not-for-profit hospitals because it postpones increased revenues from expanded coverage of previously uninsured patients and the subsequent reduction in bad debt and charity care it would bring, a Moody's report said.