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3 Rev Cycle News Stories You May Have Missed

Analysis  |  By Jasmyne Ray  
   July 03, 2024

Providers affected by the Change ransomware attack were tossed a lifeline and CMS tackles suspicious billing.

As the dust from a hectic first half of the year begins to settle, organizations are aiming for a strong finish. However, there are a few loose ends that need to be addressed.

Here are some revenue cycle news stories you may have missed.

Biden Gives Billing Arbitration Grace Period to Providers

Months after the Change Healthcare ransomware which disrupted the operations of providers across the country, many are still struggling to rebound. Some providers have been unable to begin the independent resolution process for out of network claims, being unable to access the information they need to proceed with billing.

The Biden administration, under the No Surprises Act, is giving providers until October 12 to begin the negotiation process for services provided this year, with the possibility of the deadline being extended.

HHS Rule Establishes Penalties for Information Blocking

To ensure patients and their care team have access to their health information, the Health and Human Services Department finalized a rule establishing penalties for health systems that prevent them from doing so. Various disincentives were also established to further dissuade providers from blocking patient’s access to information.

The rule, initially proposed in 2023, is backed by the 21st Century Cares Act.

Proposed Rule Targets ‘Highly Suspect’ Billing in Shared Savings Program

The Centers for Medicare and Medicaid Services (CMS) proposed a new rule to address suspicious billing activity within the Shared Savings Program. The rule excludes payouts for codes relating to significant, anomalous, and highly suspect (SAHS) claims from being used to assess the financial performance of accountable care organizations.

Jasmyne Ray is the revenue cycle editor at HealthLeaders. 


Biden administration gives providers until October 12 to begin independent resolution process for out of network claims.

HHS establishes disincentives for providers blocking patient's access to information.

CMS proposes new rule to exclude SAHS claims from calculations for ACO financial performance.

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