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Blog posts by christopher

September 20, 2023
by Christopher Martin

Holmes Heads to the Hospital: Price Transparency Meets Price Inconsistency

Sir Arthur Conan Doyle would have been quite pleased with the story coming out of a respected medical publication this month. It was as if his own creation—the character we all know as Sherlock Holmes—had cracked his latest case in the usual spectacular fashion. Undercover operatives, corporate intrigue and the circumvention of federal law—what more […]

September 13, 2023
by Christopher Martin

Opening up the Blinds: Transparency Rules for Hospitals

A few months ago, the Centers for Medicare and Medicaid Services (CMS) published a fact sheet that outlines process updates the agency is making to increase compliance with the hospital price transparency requirements. As our readers may recall, the government’s hospital price transparency requirements are authorized by section 2718(e) of the Public Health Service Act, […]

September 7, 2023
by Christopher Martin

On a Roll: Another Victory for the TMA

For the fourth time in a row, a federal judge has sided with the Texas Medical Association (TMA) in its legal challenges to regulations that implement the federal No Surprises Act (NSA).  The TMA brought another one of its legal actions back in November, alleging that certain provisions of the NSA regulations inappropriately link providers’ […]

September 5, 2023
by Christopher Martin

Navigating the Challenges of BPO Implementation in Healthcare Organizations

Business process outsourcing (BPO) is a widely adopted strategy in healthcare that allows providers and facilities to delegate administrative tasks and non-clinical functions to third-party companies. With increasing pressure to deliver high-quality patient care while reducing costs, healthcare providers are leveraging BPO to streamline their non-core functions. Outsourcing services such as medical billing, coding, and […]

September 5, 2023
by Christopher Martin

Leveraging BPO to Navigate Regulatory Compliance Challenges in Healthcare

The healthcare industry faces increasing pressure to comply with various regulations and standards, such as HIPAA and Health Information Technology for Economic and Clinical Health  (HITECH). Patients are concerned about their privacy and protected data, while providers strive to protect a patient’s information and deliver quality care. Regulations are in place to protect the privacy […]

August 30, 2023
by Christopher Martin

2024 IPPS Final Rule: Quality Programs

Over the last two weeks, we have provided the latest provisions arising from the 2024 Inpatient Prospective Payment System (IPPS) final rule released earlier this month by the Centers for Medicare and Medicaid Services (CMS). This alert will act as our final installment on the IPPS rule and will specifically focus on the CMS quality […]

August 23, 2023
by Christopher Martin

2024 IPPS Final Rule: Special Rules for Special Hospitals

There is a scene in the movie Tora, Tora, Tora where a group of sailors on a Japanese aircraft carrier excitedly gather around one of their celebrated pilots. When asked by one of the flight crew, “how did you rate another promotion,” the cocky pilot wryly remarked, “special people deserve special treatment,” which brought roars […]

August 16, 2023
by Christopher Martin

2024 IPPS Final Rule Released: What It Means for the Inpatient Hospital Setting

Earlier this month, the Centers for Medicare and Medicaid Services (CMS) published its final rule relating to payment and other policies for the inpatient hospital setting. The 2024 Inpatient Prospective Payment System (IPPS) final rule provides regulations on a wide range of issues. The following will act to summarize some of the key provisions. Payment […]

August 9, 2023
by Christopher Martin

Ghost in the Machine: Payer Programming Auto-Denies Claims?

In May of 1999, Vice President Al Gore made a startling assertion to CNN’s Wolf Blitzer: “During my service in the U.S. Congress, I took the initiative in creating the Internet.” Wow! I guess that’s why we talk in terms of computer Al-Gor-ithms to this day (cue the “bah-dah-boom” on the snare and cymbal). Of […]

August 2, 2023
by Christopher Martin

2024 OPPS Proposed Rule: Recommendations for Rural Hospitals

“Take me home, country roads, to the place I belong.” So begins the iconic chorus to one of America’s favorite tunes dedicated to rural settings and down-home living. While most of our citizens live in urbanized areas, with ready access to an array of services and conveniences, those who dwell in the hills and hollers […]