Regulatory Updates​

The Appropriate Use Criteria Program ensures providers who order outpatient imaging services have medical necessity to do so. … Read More

SCOTUS found HHS correctly calculated safety-net payments. Hospitals caring for low-income patients could see payments negatively impacted. … Read More

Find responses to frequently asked questions about Good Faith Estimates and helpful No Surprises Act-related resources. … Read More

How to comply with the rules for uninsured or self-pay individuals, including everything you need to know about a Good Faith Estimate (GFE). … Read More

Providers initiate the independent dispute resolution process if they think the amount remitted by an out-of-network payer is insufficient. … Read More

Under the No Surprises Act, a non-participating/OON provider cannot balance bill patients unless they provide the standard notice and consent. … Read More

The No Surprises Act (NSA) requires providers and facilities to communicate consumer protections against balance billing. … Read More

Take a deep dive into the No Surprises Act (NSA) and its requirements for billing insured, out-of-network patients. … Read More

One key change in CMS’ 2022 Medicare OPPS/ASC proposed rule is the reversal of last year’s initiative to eliminate the inpatient-only list. … Read More

Procedures added or deleted from the Inpatient-Only List directly impact the financial health of hospitals. … Read More