It 's Been A Year. Have You Felt The Impact?

DHShas released its first annual report on how the No Surprises Act is impacting health care markets, and the results are both surprising and expected.

Among the crucial findings are the decrease and concentration of out-of-network billing, both claims and the total amount associated with those claims; trends regarding changes in hospital ownership; and horizontal consolidation and pass-through costs to consumers

Join us as we analyze the findings and what they mean to the industry going forward We will also discuss the key factors that play a role in the DHS?evaluation of NSA and what they might mean for market trends, consolidation, and out-of-network billing.

About Barbara Johnson, BSN, RN ?Senior Revenue Cycle Consultant

Leading the series is CorroHealth?s resident subject matter expert, Barbara Johnson, BSN, RN ? Senior Revenue Consultant. As a registered nurse Johnson worked in emergency medicine before transitioning into nursing administration She entered the specialty of Revenue Integrity as a nurse auditor where she expanded her knowledge of coding and revenue cycle compliance through membership in AAPCand HFMA Today, she is CorroHealth?s leading subject matter expert on NSA.

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CorroHealth?s ?No Surprises Act and Price Transparency, a New Monthly Series?was created to provide attendees with clarity around No Surprises Act, to answer questions, and get you on the best path for success The series also clarifies payers?increased role in the process, the status of impactful legislation, and the processes providers should follow to comply

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Protecting Access To Medicare (PAMA) Lab Delay

Quest ion:

With PAMA moving reporting period to January - March, 2024, would you suggest we wait to report any data for any regulatory changes between now and then?

Answ er:

It is not yet possible to submit lab payment data to CMS, as the online reporting portal is not open and will not be opened until the reporting period begins.

Late last year, Congress delayed (for the fourth time) the reporting period for payment data collected in 2019 to the first quarter of 2024. Meanwhile, a bill titled the Saving Access to Laboratory Services Act (SALSA) has been re-introduced into both houses of Congress; the SALSA Act would substantially revise the reporting requirements going forward, and would eliminate reporting the 2019 data altogether The proposed legislation has been referred to congressional committees in both the House of Representatives and in the Senate ? but no hearings have been scheduled to discuss the proposed legislation We may not know the fate of the SALSA Act until the end of this Congressional session.

Our paper regarding the proposed SALSA Act is attached If it is not signed into law, Congress will have to decide whether to extend the reporting period yet again ? but 2019 data is less and less relevant to determine future rates of payment under the Clinical Lab Fee Schedule

CorroHealth will continue to report as information about the SALSA Act and/or the next data reporting period comes to light. Please keep reading our eJournal for future updates