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Why Are Hospitals Fighting Site-Neutral Payments So Fervently?

Establishing site-neutral payments for outpatient services is a hot issue in Capitol Hill right now. Advocates say that such policy would lower healthcare costs, saving both patients and taxpayers money. Opponents say that it would put hospitals’ financial security at risk and jeopardize access to care. ....

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'A step in the right direction': Payer, provider groups weigh in on new prior authorization rule

Six payer and provider organizations share their thoughts on the prior authorization rule CMS finalized Jan. 17. ....

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ASCs vs. HOPDs: 3 cost comparisons

Compare the financial benefits of having procedures done at ASCs vs. HOPDs. ....

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COVID vaccine rollout issues largely fixed, insurers tell US health agency

"At this time, we understand that systemic technical issues have been largely, if not completely, resolved and are not limiting patient access to vaccines," representatives for many U.S. health plans wrote in a letter to HHS. The missive came in response to a letter HHS Secretary Xavier Becerra wrote last Friday. HHS raised concerns in their letter regarding some customers experiencing insurance coverage denials when they wanted the updated COVID-19 vaccines. ....

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Insurers Slam CMS for Medicare Advantage RADV Final Rule

The final rule calls for stricter audits on Medicare Advantage plans. AHIP president and CEO Matt Eyles referred to the rule as "unlawful and fatally flawed." ....

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