Commercial Insurer Accountability
The AHA Oct. 17 released its Health Care Plan Accountability Update, covering the latest developments in Medicare Advantage, legislation and regulation of private health insurers, as well as other resources from the last quarter.
Health Plan Accountability Update -for October 2024.
While lawmakers are in their district, it is important for the field to engage with members of Congress to remind them of the importance of preserving access to care by continuing to fund vital programs like telehealth and hospital-at-home waivers, and avoiding harmful policies such as site-neutral…
Clinical validation audits are a new tactic that certain commercial insurers are adopting to reduce or deny payment to health care providers and can take months or even years to be adjudicated and resolved.
. In this conversation, Richelle Marting, director of managed care contracting at North Kansas City Hospital, and Chris Thompson, executive director of reimbursement and compliance for managed care at AdventHealth, discuss the rapid growth in these audits, the financial strain they can put on…
There will always be administrative costs associated with operating a hospital. But the lion’s share of a hospital’s resources should be devoted to doing what hospitals do best: provide safe, accessible and exceptional patient care to anyone who needs it.
The House Education and Workforce Committee advanced several bills today, including legislation that would empower commercial insurance companies at the expense of patients and a bill that would ban facility fees for telehealth visits.
The AHA is providing feedback on the Healthy Competition for Better Care Act (H.R. 3120) and the Transparent Telehealth Bills Act of 2024 (H.R. 9457).
Hospitals and health systems are seeing significant increases in administrative costs, including due to burdensome practices by commercial insurers that often delay and deny care for patients, according to a new report released Sept. 10 by the AHA.
Between 2022 and 2023, care denials increased an average of 20.2% and 55.7% for commercial and Medicare Advantage (MA) claims, respectively.