Bulletin Board
Bulletin Board
CMS Takes an Axe to the Fax
The days of sending health care claims forms and claims-related documents by fax and regular U.S. mail are fast drawing to a close. Last week the Centers for Medicare & Medicaid Services announced that it will adopt a new regulation – “The Administrative Simplification; Adoption of Standards for Health Care Claims Attachments Transactions and Electronic Signatures Final Rule” – that will establish HIPAA-compliant standards for sharing health care claims attachments, enabling the secure electronic exchange of health care claims-related supporting clinical documentation and attachments such as medical records, x-rays and [...]
No Surprises Act Activity in 2025
A new Health Affairs report offers a preliminary look at No Surprises Act Independent Dispute Resolution activity for 2025. Among its findings: Providers and facilities initiated 99.9 percent of the disagreements submitted to the IDR process. Four provider groups or representatives of provider groups initiated more than half of those cases. Providers prevailed in 88 percent of the cases. Health plans challenged 40 percent of the cases submitted to the IDR process as ineligible for adjudication under that process. The IDRs upheld their challenges only 17 percent of the time. [...]
Looking Ahead to New Health Plan Price Transparency Requirements
If the new health plan price transparency requirements proposed by the Centers for Medicare & Medicaid Services are finalized later this year and implemented a year later, as anticipated, they will usher in significant changes in available data for use by consumers, providers, and businesses that collect, analyze, package, and sell such data. The anticipated changes in transparency requirements could include: Specific identification of rate changes from the most recently published rate. Reduced file sizes that eliminate some currently required data and a requirement that health plans post a single [...]
Telehealth May Discourage Low-Value Testing
A new study suggests that greater adoption of telehealth may be accompanied by reduced utilization of low-value medical testing – diagnostic tests, screenings, or procedures that seem to provide little to no clinical benefit to the patient and are increasingly considered unnecessary tests that waste resources despite evidence-based recommendations that they be prescribed less often. The study found that patients served by medical practices that embraced telehealth had slightly more overall visits a year but underwent fewer of seven of the 20 major low-value medical tests, many of which are [...]
Federal Health Policy Update for March 19
The following is the latest health policy news from the federal government for March 13-19. Some of the language used below is taken directly from government documents. The White House President Trump has issued an executive order creating a Task Force to Eliminate Fraud that “…shall, on behalf of the President, coordinate and accelerate a comprehensive national strategy to stop fraud, waste, and abuse within Federal benefit programs, including programs administered jointly with State, local, tribal, and territorial partners.” The vice president will chair the task force, the Secretary of [...]