News

Appeal when a hospital changes your status from an inpatient to an outpatient with observation services

Earlier this year, the US Court of Appeals for the Second Circuit issued a decision on Barrows v. Becerra, a […]

CMS Seeks Public Feedback to Improve Medicare Advantage

Submit your comments! Here is your opportunity to sound off the CMS regarding the Medicare Advantage program. The Centers for […]

Implanted Spinal Neurostimulators: Document Medical Records

In a recent report, the Office of Inspector General found that Medicare improperly paid claims for implanted spinal neurostimulators when providers […]

KFF’s Kaiser Health News and NPR Launch Diagnosis: Debt, a Yearlong Reporting Partnership Exploring the Scale, Impact, and Causes of the Health Care Debt Crisis in America

About 4 in 10 Adults Have Some Debt Due to Medical or Dental Bills, Finds a National KFF Survey Conducted […]

The Office of Inspector General Issues its Semiannual Report to Congress

The U.S. Department of Health and Human Services Office of Inspector General has issued its semiannual report to Congress covering […]

They Thought They Were Buying Obamacare Plans. What They Got Wasn’t Insurance.

Bram Sable-Smith June 7, 2022 As published by khn.org/news Tina Passione needed health insurance in a hurry in December. The […]

PAYERS FAILING TO FOLLOW THROUGH ON PRIOR AUTHORIZATION REFORMS

ANALYSIS  |  BY JAY ASSER  |   JUNE 02, 2022 A physician survey by the American Medical Association (AMA) reveals the administrative burden still […]

Insurer groups issue report showing the No Surprises Act’s early impact on patient billing

May 27, 2022 By Nick Hut As reported on hfma.org Blog | Billing and Collections Insurer groups issue report showing the No […]

Medicare Appeals Decision Search (Part C & Part D)

With little (no?) fanfare, CMS published a decision database of summaries of the Qualified Independent Contractor’s (QIC) decisions on Part […]

Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care

WHY WE DID THIS STUDY A central concern about the capitated payment model used in Medicare Advantage is the potential […]