Posts by Sam Norton:
CMS Seeks Funds from Congress to Bolster QIC Operations
The Centers for Medicare and Medicaid Services (“CMS”) recently released its budget proposals for fiscal year (“FY”) 2022, requesting funding to facilitate Qualified Independent Contractors’ (“QIC”) operations at both the …
- Posted on: Aug 3 2021
CMS Releases Its Hospital Inpatient Prospective Payment System Proposed Rule for FY 2022
On May 10, 2021, the Centers for Medicare and Medicaid Services (“CMS”) published a proposed rule updating Medicare policies under the acute-care hospital inpatient prospective payment system (“IPPS”) for fiscal …
- Posted on: Jun 18 2021
United Healthcare to Switch from Milliman to InterQual
In a bulletin posted February 1, UnitedHealthcare (UHC) announced that “We will transition to InterQual criteria for all benefit plans effective May 1, 2021.” Although not specified in the announcement, the implication is …
- Posted on: Feb 8 2021
2021 Not Likely to Bring Return to Normal for Hospitals
2020 has been unprecedented in many ways. As the grim year ends on a more hopeful note – with frontline healthcare workers receiving the first doses of the COVID-19 vaccines …
- Posted on: Jan 4 2021
A Biden Administration Could Mean Change for Hospitals but Continuity on Many Issues
With Democratic presidential candidate Joe Biden now widely acknowledged as the president-elect of the United States, the nation’s attention has turned to the question of what to expect when the …
- Posted on: Nov 11 2020
Even with Public Health Emergency Extended, Providers Can’t Relax About Denials
On October 2nd, US Secretary of Health and Human Services (HHS) Alex Azar extended the public health emergency (PHE) due to COVID-19 for another 90 days beyond the previous expiration …
- Posted on: Oct 8 2020
Payers Pledge Support for COVID Care, But Gaps in Promises May Lead to Denials
With the COVID-19 pandemic still in full force across the United States, payers are trying to reassure patients and providers that they have no need to worry about the cost …
- Posted on: Sep 24 2020
With Claims Volumes Still Low, Payers Open Their Wallets to Meet Medical Loss Ratios
With COVID-19 cases surging throughout much of the US this summer, hospitals face a grim financial picture. As expenses increase and patients continue to stay away, hospitals have seen a …
- Posted on: Aug 31 2020
As Pandemic Ebbs, Hospitals Could See a Flood of Denials
Although the COVID-19 pandemic is far from over, most states have seen encouraging trends in recent weeks, with decreases in new cases and deaths attributable to the virus. With the …
- Posted on: Jun 10 2020
New Hospital Reimbursement Policies During COVID-19 Outbreak Will Help, But Hospitals Must Have a Clear Protocol to Avoid Denials
Note: This article was originally written on April 8, 2020. It was revised on April 15, 2020 to reflect new developments. The situation continues to change by the day. As …
- Posted on: Apr 28 2020