Each July, the Medicare Administrative Contractors issue notices of a 2% Medicare payment reduction to those providers who did not meet quality data reporting requirements. Those notices have been sent. In this episode, Husch Blackwell’s Meg Pekarske and Jacob Harris talk about the issues providers faced in 2021 and how to pursue an appeal of
On October 1, 2020 the Department of Health and Human Services (“HHS”) announced that it will distribute a total of $20 billion as part of Phase 3 of the Provider Relief Funds. The application for Phase 3 funding is now open and will be available from October 5 – November 6, 2020. However, HHS has urged providers to apply early, which may be an indication that the funds will be available on a first-come first-serve basis.
Below are some key details regarding Phase 3:
In this episode, Meg Pekarske talks with Michael McHale who is President and CEO of TRU Community Care. Michael is a friend, colleague and hospice innovator. As a former board member of the National Hospice and Palliative Care Organization (“NHPCO”), Michael is always thinking of ways to lead proactive growth and change. He is driven
There is a trend in healthcare toward customer-centrism—placing the interests of the consumer before all other considerations. The trend may be slow in its growth, but for those healthcare organizations that embrace the idea and obsess over improving the consumer’s experience throughout their healthcare journey, there can be a payoff. But improving consumer experience in healthcare takes a commitment and courage to venture outside of traditional comfort zones.
For years, the polarized debate over healthcare policy has included advocacy for a more consumer-directed healthcare system. The argument in favor says consumers and providers alike must have more skin in the game—financial responsibility—and better information with which to make more consumer-like decisions. For providers, the “skin” means risk-based contracts. For consumers, it means higher deductibles and other out-of-pocket cost exposure. There has been significant movement in this direction.
The out-of-network (OON) business model faces challenges as the result of changes to health and benefit plan OON coverage, but a ruling by Judge Hoyt of the U.S. District Court for the Southern District of Texas suggests that health plans should be careful in refusing payment based on perceived OON high charges, questions about OON co-insurance collection, or provider financial arrangements.