Federal regulations require written consent for pelvic exams at hospitals, medical schools
Editor's Note New federal guidelines require obtaining written informed consent before conducting pelvic and other sensitive medical examinations, according to an April 2 Associated Press report. The new guidance from the US Department of Health and Human Services focuses specifically on medical students, nurse practitioners, and physician assistants performing breast,…
Private payers profit by delaying medical claims
Editor's Note Private payers initially deny reimbursement on 15% of claims, only to later approve more than half of those initial denials, according to a national survey of healthcare institutions published March 21 by Premiere, Inc. Additionally, the denied claims on average tend to be more prevalent for higher-cost treatments…
Federal probe investigates care quality impact of private equity mergers, acquisitions
Editor's Note Making good on plans announced by the Biden administration in December, federal agencies have launched a public inquiry into how private equity mergers and acquisitions impact patient outcomes, worker safety, and healthcare access and costs, including costs to taxpayers. As reported by Dotmed Healthcare Business News on March…
Shift to outpatient, emergency services keeps rural hospitals afloat
Editor's Note More CEOs are considering rural emergency hospital (REH) designation, according to a February 12 article in Becker’s Hospital CFO Report. In 2021, REH was established as a new Medicare provider type to enable struggling rural hospitals to continue operating with outpatient and emergency services only, instead of closing.…
CMS reforms prior authorization to improve care, streamline physician process
Editor's Note The Centers for Medicare & Medicaid Services (CMS) has implemented a final rule reforming the prior authorization process, with the aim to reduce delays in patient care and boost electronic efficiency for physicians, the American Medical Association (AMA) News Wire reported January 23. The Department of Health and…
Bipartisan congressional letter calls for end to Medicare payment cuts
Editor's Note Nearly 200 members of Congress co-signed a letter urging House and Senate leaders to act quickly in order to prevent a 3.37% cut to Medicare reimbursement payments that was scheduled to take effect on January 1, 2024. The American Medical Association, which supports the effort, reported the news…
Why screening misses critical influences on patient health
Editor's Note Health record codes that track social, environmental, and economic influences on patient health outcomes are vastly underutilized during screening, according a December 19 EurekAlert! report on research from John Hopkins and the University of Colorado Anschutz Medical Campus. Published in Health Affairs Scholar, the study analyzes the…
Bill seeks to improve cost transparency, provide relief to patients
Editor's Note The US House of Representatives may vote this week on The Lower Costs, More Transparency Act. Introduced September 8, the proposed act aims to boost healthcare pricing transparency so consumers can make more informed decisions. Key elements include: Hospitals, payers, ambulatory surgery centers (ASCs), and other facilities would…
ASCs lock in higher Medicare, Medicaid payment rate
Editor's Note Ambulatory Surgery Centers (ASCs) will now receive a 3.1% payment rate from the Centers for Medicare and Medicaid Services (CMS) for services, which is an increase of .3% under the original rule, Becker’s ASC Review December 5 reports. This change in payment rate reflects the average of all…
Healthcare costs making Americans poorer, sicker
Editor's Note The high cost of healthcare is leading many Americans to skip care and forgo medications, according to the 2023 Healthcare Affordability Survey by the Commonwealth Fund published on October 26. Some highlights of the survey include: A large number of insured working-age adults surveyed admitted difficulty affording their…
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