Reimbursement
Providers haven't been responding to Low Utilization Payment Adjustment thresholds as expected, the analysis finds.
In response to what AHIP said was price gouging, the organization has called for policy changes to stop the practice from continuing.
Failing to initially show a positive test result for a coronavirus patient could lead to appeals and administrative headaches.
At stake is $3.2 billion in revenue for a one-day length of stay as 80% of revenue for all services is in joint replacement.
Many U.S. hospitals have already seen revenues impacted due to delayed or re-prioritized nonemergency procedures.
The new rule also requires hospitals to provide COVID-19 cases and related data to the U.S. Department of Health and Human Services.
Humana says it was billed millions of dollars for fraudulent prescription claims and members received unwanted expensive creams.
The flexibilities have been made available to "enhance payment" for nursing homes that have implemented COVID-19 infection-control practices.
At the heart of the legal battle is whether the ACA can stand without the tax mandate for individuals to have health insurance.
The COVID-19 pandemic has created a volatile environment, and there's a long road ahead to recovery.