Eye on Enforcement / CMS Issues First Penalties for Two Hospitals Violating Price Transparency Rules

REGULATORY UPDATE CMS Inspecting Hospital Websites for Compliance SNAPSHOT On June 7, 2022, the Centers for Medicare and Medicaid Services (CMS) imposed civil monetary penalties (CMPs) against two hospitals for noncompliance with the agency’s price transparency requirements. The hospitals violated the requirements by failing to update their websites and/or respond to CMS’ letters about the

Read More

Eye on Enforcement / 340B Drug Pricing Program Developments

REGULATORY UPDATE Drug Companies Continue to Restrict Pricing Access, Financial Impact to Hospitals Increases SNAPSHOT Public and non-profit hospitals participating in the federal 340B Drug Pricing Program continue to face financial and operational challenges related to drug manufacturer policies that restrict access to 340B prices. A recent 340B hospital survey showed the median annual losses

Read More

RPA to AI and Beyond

By GRANT VEAZY, Chief Technology Officer, Ensemble Health Partners An Evolution in Healthcare Facility Operations Technology SNAPSHOT Over the past decade and a half, we’ve seen incredible advancements in healthcare operations technology. As costs and regulations across the board have risen, these technologies have allowed modern providers to increase employee efficiency, reduce redundancies, streamline patient

Read More

Eye on Enforcement / Certain Pandemic Telehealth Services Continue While Enforcement Efforts Increase

REGULATORY UPDATE Certain Pandemic Telehealth Services Continue While Enforcement Efforts Increase SNAPSHOT A flurry of government activity surrounding telehealth services surfaced last month, showing signs of continued support. And with it, recognition of associated fraud and quality concerns.  More recently, Washington leaders are preparing for a post-pandemic phase. Providers will need to monitor the changing

Read More

Can You Even Break Even?

The average hospital’s operating margin is -4.0%. Operating expenses are up 30% compared to last year and inflation is at a 40-year high. With only a 3.2% increase to Medicare IPPS rates for 2023, how are hospitals expected to keep up?

Read More

Eye on Enforcement / COVID-19 Fraud is Now a Government Top Priority: Are You Ready?

REGULATORY UPDATE COVID-19 Fraud is Now a Government Top Priority: Are You Ready? SNAPSHOT The U.S. Department of Justice (DOJ) and the U.S. Department of Health & Human Services Office of the Inspector General (HHS-OIG) are rapidly stepping up nationwide efforts to identify and combat civil and criminal fraud related to COVID-19 funding, and stakeholders

Read More

Quick Take: Good Faith Estimates Create Administrative Burden for Hospitals

A recent article from RevCycle Intelligence reports: “The American Hospital Association (AHA) has asked the Centers for Medicare & Medicaid Services (CMS) to adjust the good faith estimates policy under the No Surprises Act, citing the accompanying administrative burden and operational inefficiencies as problems for hospitals and health systems.” In their letter, AHA wrote: “The government has

Read More