Surprise Billing

ACOs Flock to CMS Shared Savings Program, NSA Averts Surprise Billing

January 31, 2024 - The CMS Medicare Shared Savings Program (MSSP) saw an uptick in accountable care organization (ACO) involvement. The agency announced that 480 ACOs are participating in the MSSP and 245 organizations are involved in two CMS Innovation Center ACO models. As a result of these and other efforts, nearly half of all Traditional Medicare...

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CVS, Walgreens Employees Strike, Patients Support Sharing Wearable Data with Docs

by Editorial Staff

Employees at Walgreens and CVS Health are going on strike to end harsh working conditions. Without a strong union presence, coordination has been difficult and the companies say previous strikes have...

CDC Ends Some Coronavirus Restrictions, Medicare Changes Under New Act

by Hayden Schmidt

Late last week, CDC introduced new guidance for dealing with coronavirus cases, removing several restrictions as the number of cases continues to rise throughout the country. Revised guidance will lift...

Montana Governor Funds HIE, CO Supreme Court Rules on Surprise Billing

by Hayden Schmidt

Montana’s governor plans to utilize federal and private funds to increase access to a statewide HIE system. The effort is considered a critical investment for the largely rural state. Also, in...

FDA Approves Remdesivir for Infants, Surprise Billing Battle Persists

by Hayden Schmidt

The FDA is promoting the use of an antiviral, Remdesivir, to treat COVID-19-infected infants after the drug was shown to be effective in a small clinical trial. Meanwhile, HHS asked a federal appeals...

Google to Bring Artificial Intelligence to Health, Maternal Health

by Kyle Murphy, PhD

Google continues its push into healthcare, this time with applications of artificial intelligence to improve cardiovascular and maternal health. Google AI Efforts to Focus on Heart, Maternal...

Another Payer Launches a Remote Patient Monitoring Program

by Kyle Murphy, PhD

With remote patient monitoring proving to be a valuable tool for timely and effective care management, more and more payers are standing up their own RPM programs to benefit their members and...

Payers Cover Coronavirus Tests, Physicians Oppose Surprise Billing Act

by Hayden Schmidt

This week, CMS announced a new rule requiring commercial insurance groups to cover the cost of coronavirus tests for their members. Insured Americans will now qualify for eight free tests per...

Overall Telehealth Use Decreases, But Telemental Care Increases

by Kyle Murphy, PhD

The pandemic continues to wear on the psyche, increasing stress, fatigue, and a general sense of malaise. But telehealth is removing obstacles to mental healthcare. Telehealth Use Dips Overall,...

How 3 Policies are Changing the Healthcare Payer Landscape

by Hayden Schmidt

In a new report from Insights by Xtelligent Healthcare Media, three recent healthcare rules are examined and their effects on payers are measured. The first of the three regulations examined, the No Surprises Act, aims to protect...

How to Pursue Standardization in Surprise Billing Compliance

by Kelsey Waddill

Surprise billing is a burden on patients and healthcare stakeholders alike, but the healthcare industry has had difficulty confronting this problem due to a lack of uniformity. “Surprise billing...

States Expand CMS Operations, NIH Director Resigns

by Hayden Schmidt

Funds from the American Rescue Plan were used in several states to initiate healthcare marketplaces. Kentucky, Maine, and New Mexico joined 14 other states that had already established their...

Administration Boosts Funding to Increase Access to Care, Cybersecurity

by Emily Sokol, MPH

As the holiday weekend comes to a close, the Biden Administration did not slow its commitment to increasing access to care for patients. Through American Rescue Plan funding, CMS allocates funding to...

CMS Proposes ESRD Value-Based Payment, Surprise Billing Final Rule

by Emily Sokol, MPH

CMS proposed a value-based payment model for the treatment of end-stage renal disease and released a final ruling to combat surprise billing. Meanwhile, Congress introduced a bill to expand broadband...

Marketing Linked to Billions in Medicare Drug Spending; AHA to Square Off Against HHS Before SCOTUS

by Kyle Murphy, PhD

Welcome back to work after a long (and for many in the Northeast rainy) weekend. Direct-to-consumer marketing appears to be paying off for pharma companies as far as Medicare drug spending is...

US Pauses Distribution of Eli Lilly COVID-19 Antibody; Ground Ambulance Rides Lead to Surprise Billing

by Kyle Murphy, PhD

United States officials have paused the distribution of Eli Lilly’s COVID-19 antibody therapy after it proves ineffective against variants. New research shows the ground ambulance rides are...

Downside of Automated Patient Messages; End in Sight for Surprise Billing

by Kyle Murphy, PhD

The pandemic has taught the healthcare industry a considerable deal about patient engagement, but it has also shown that too much of a good thing can turn patients away. While surprise billing was all...

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