PYA Webinar Recast

Federal rule makers have been extremely busy this spring, releasing the fiscal year (FY) 2025 proposed payment rules as well as new final rules on nursing home staffing requirements, state Medicaid program operations, non-compete agreements, and compensation thresholds for overtime pay. PYA’s Kathy Reep and Martie Ross discussed key provisions of the following proposed and final rules impacting healthcare providers: FY 2025 Hospital Inpatient Prospective Payment System (PPS) and Long-Term Care Hospital PPS Proposed Rule FY 2025 Hospice Payment Rate Update Proposed Rule FY 2025 Skilled Nursing Facility PPS Proposed Rule FY 2025 Inpatient Psychiatric Facility PPS Proposed Rule FY 2025 Inpatient Rehabilitation Facility PPS Proposed Rule Minimum Staffing Standards for Long-Term Care Facilities & Medicaid Institutional Payment Transparency Reporting Final Rule Ensuring Access to Medicaid Services Final Rule  Medicaid and CHIP Managed Care Access, Finance, and Quality Final Rule Federal Trade Commission Non-Compete Clause Final Rule Department of Labor Overtime Pay Final Rule Health Resources & Services Administration 340b Administrative Dispute Resolution Final Rule Office of Civil Rights Non-Discrimination in Health Programs and Activities Final Rule This webinar took place on May 8, 2024 and is part of PYA’s twice-monthly Healthcare Regulatory Roundup, a popular series during which PYA experts provide practical insights on the latest industry regulatory developments. If you would like assistance with legislative or regulatory impacts or any matter involving compliance, valuation, or strategy and transactions, one of our executives would be happy to assist. You may email them or call (800) 270-9629. Attendees of the live webinar were eligible for 1.5 CPE credits in Specialized Knowledge.

The 2024 Hospital Outpatient Prospective Payment System Final Rule included significant changes to the requirements for hospitals to post standard charges and other pricing information. Hospitals must comply with the most substantive changes by July 1, 2024. PYA’s Martie Ross and Kathy Reep provided guidance to hospitals working to meet this deadline. Specifically, Martie and Kathy addressed these important points: Website posting requirements Standardization of machine-readable files New data elements Algorithmic rates Attestations Looking forward to January 1, 2025, requirements Responding to third-party criticism Enforcement update The webinar took place on April 24, 2024. This webinar was part of PYA’s twice-monthly “Healthcare Regulatory Roundup” series in which experts from across the firm provide practical insights on the latest regulatory developments. If you would like assistance with price transparency issues, or any matter involving compliance, valuation, or strategy and transactions, one of our executive contacts would be happy to assist. You may email them, or call (800) 270-9629.

This webinar was Episode 3 of PYA’s new Revenue Recharge series. In the series, PYA shares ways health systems and physicians can identify revenue opportunities, leading to a more sustainable and visionary future and better healthcare for patients. By addressing net revenue opportunities in your operational planning, you can support your mission. The webinar took place May 2, 2024. During this webinar, Principal Jane Jerzak and Principal and Director of Business Intelligence & Analytics Jason Hardin discussed many aspects of managed care contracting. Specifically, they covered the following key points: How to identify gaps in expected vs actual reimbursement Lessons learned in developing analytical models for payer reimbursement proposals How to monitor contract performance and promptly address reimbursement issues Watch for more episodes of the Revenue Recharge webinar series. If you would like assistance with revenue management and strategies or any other area related to healthcare operations, strategy and transactions, or valuation, one of our executives would be happy to assist. You may contact them via email or by calling (800) 270-9629.

In 2024, PYA surveyed more than 100 physician compensation experts and other healthcare professionals to understand their toughest, timeliest, and trickiest topics in FMV and physician compensation Additionally, we collected questions submitted during our recent webinar, “Top 10 High-Demand Physician Specialties,” to learn what is most meaningful to you. During this webinar, PYA Principal Lyle Oelrich and Manager Aaron Newcomer addressed your questions: How do you reconcile the current rate of wage inflation with the time lag in published benchmarking surveys? How do you navigate rising starting bonuses in competitive markets without busting the budget? What types of physician compensation models are losing and/or gaining momentum? How do you compensate providers who are extremely productive or unproductive? The webinar took place on April 16, 2024. This webinar was part of the Timely, Tough, or Tricky series, now in its third successful season. Information about upcoming episodes, as well as on-demand recordings of past sessions, can be found on the series landing page. Also, follow PYA on LinkedIn to learn about upcoming webinars. PYA performs more than 1,200 fair market value opinions and reviews or develops hundreds of physician compensation plans each year. If you would like assistance with physician compensation, fair market value, or any matter involving valuation, compliance, or strategy and integration, one of our executives would be happy to assist. Contact them via email or by calling (800) 270-9629.

The explosive growth in Medicare Advantage (MA) enrollment over the last decade is significantly impacting providers’ bottom lines. During a webinar presented on April 10, 2024, PYA’s Martie Ross and Kathy Reep discussed regulations impacting MA plans and providers’ interactions with the plans. Specifically, Martie and Kathy addressed these important points: 2025 MA rate announcement Prior authorization final rule Coverage criteria and utilization review regulations Impact of changes to the Centers for Medicare & Medicaid Services-HCC risk adjustment model MA enrollment and marketing restrictions Out-of-network payments for emergency services MedPAC report on MA reform The webinar was part of PYA’s twice-monthly Healthcare Regulatory Roundup, a popular series during which PYA experts provide practical insights on the latest industry regulatory developments. If you would like assistance with legislative or regulatory impacts or any matter involving compliance, valuation, or strategy and transactions, one of our executives would be happy to assist. You may email them or call (800) 270-9629.

This webinar is Episode 2 of PYA’s new Revenue Recharge series. In the series, PYA shares ways health systems and physicians can identify revenue opportunities, leading to a more sustainable and visionary future and better healthcare for patients. By addressing net revenue opportunities in your operational planning, you can support your mission. The webinar, Revenue Recharge: “Back-End Revenue Cycle,” took place March 28, 2024. PYA Principal Bob Paskowski and Senior Manager David Hall discussed revenue opportunities through the back-end revenue cycle. Attendees learned from these objectives: Engaging with payers: Understand current national trends in payer denial activity and how to prepare a defense against these activities Avoiding denials and underpayments: Learn the importance of understanding and maximizing the use of your billing application functionality to avoid, analyze, and track denials and underpayments Plugging the leaks: Evaluate the critical role of comprehensive policies and procedures to guard against hidden revenue leakage Realizing revenue: Learn from Paskowski and Hall’s experiences to help you realize greater net revenue Watch for more episodes of the Revenue Recharge webinar series. If you would like assistance with revenue management and strategies or any other area related to healthcare operations, strategy and transactions, or valuation, one of our executives would be happy to assist. You may contact them via email or by calling (800) 270-9629.

The November 2023 release of the Office of Inspector General’s (OIG) General Compliance Program Guidance (GCPG) provides an opportunity for hospitals, health systems, and other healthcare entities to evaluate their current compliance programs.  To help providers understand and apply the GCPG, PYA presented a webinar, “2024 GCPG – Updates, Key Insights, & Recommendations”, on March 20, 2024. During the webinar, PYA Principal Tynan Kugler, Consulting Principal Shannon Sumner, and Senior Consulting Manager Traci Waugh provided a general overview of the GCPG including: Key risk areas of the GCPG Most notable updates, changes, and emphasis by the OIG since the original release of Compliance Program Guidance in the Federal Register  Attendees also: Learned about recent enforcement actions for consideration by compliance officers when developing their 2024 compliance work plans Received practical recommendations for incorporation into an organization’s compliance program effectiveness plan This webinar is part of PYA’s twice-monthly Healthcare Regulatory Roundup (HCRR), a popular series during which PYA experts provide practical insights on the latest industry regulatory developments. If you would like assistance with healthcare regulatory compliance, developing a compliance program, legislative or regulatory impacts, or any matter involving compliance, valuation, or strategy and transactions, one of our executive contacts would be happy to assist. You may email them or call (800) 270-9629. Attendees of the LIVE webinar were eligible for 1 CPE* credit in Specialized Knowledge. 

PYA Principals Lyle Oelrich and Zach Doolin kicked off the 2024 Timely, Tough, or Tricky (TTT) webinar series by unveiling PYA’s list of the Top 10 high-demand physician specialties. By performing more than 1,200 fair market value opinions and reviewing or developing hundreds of physician compensation plans each year, PYA is exposed to the physician specialties in various markets that are in hot demand and why, which might be a lack of supply, growth in compensation from year to year, evolving compensation formulas, or a host of other specialty-specific issues. Specifically, during this webinar, attendees learned from the presenters as they: Unveiled PYA’s Top 10 physician specialties and discuss the reasons they made our list Briefly recapped key topics covered in Seasons 1 and 2 of the TTT webinar series Solicited feedback for future webinars on the timely, tough, or tricky FMV and physician compensation issues facing your organization If you would like assistance with physician compensation, fair market value, or any matter involving valuation, compliance, or strategy and integration, one of our executive contacts would be happy to assist. Contact them via email or by calling (800) 270-9629.

Federal and state cybersecurity initiatives are getting a big boost in 2024. From the White House to the governor’s mansion, everyone seems to be getting on the same page (or at least in the same book) when it comes to cybersecurity in healthcare. PYA’s Barry Mathis highlights recent guidance and regulations intended to increase accountability and decrease “where do I start” concerns relating to cybersecurity and the protection of personal and protected healthcare data. Listeners will: Receive an update on changes to existing cybersecurity guidelines and Be introduced to new federal and state guidelines and requirements. This webinar is part of PYA’s twice-monthly Healthcare Regulatory Roundup (HCRR), a popular series during which PYA experts provide practical insights on the latest industry regulatory developments. Learn about PYA’s comprehensive risk management program, Overwatch. If you would like assistance with cybersecurity compliance, information technology infrastructure, legislative or regulatory impacts, or any matter involving compliance, valuation, or strategy and transactions, one of our executive contacts would be happy to assist. You may email them or call (800) 270-9629.

This webinar was Episode 1 of PYA’s new Revenue Recharge series. In the series, PYA shares ways providers (health systems and physicians) can identify revenue opportunities, leading to a more sustainable and visionary future and better healthcare for patients. By addressing net revenue opportunities in your operational planning, you can support your mission. The first webinar, Revenue Recharge: Front and Middle Revenue Cycle Improvement, took place on February 22, 2024. PYA Principals Sarah Bowman and Kristen Davidson discussed revenue opportunities through front and middle revenue cycle process improvement. This session included these learning objectives: Gain best practices for front-end data accuracy and point-of-service collections; Assess impact on reimbursement by consistently reviewing your charge description master (CDM) and fee schedules; Audit for comprehensive documentation and appropriate code assignment to minimize medical necessity denials and down coding. Bowman and Davidson also discussed specific areas for operational improvements to help you realize greater net revenue. Watch for more episodes of the Revenue Recharge webinar series. If you would like assistance with revenue management and strategies or any other area related to healthcare operations, strategy and transactions, or valuation, one of our executives would be happy to assist. You may contact them via email or by calling (800) 270-9629.

Federally designated rural health clinics (RHC) receive enhanced Medicare and Medicaid reimbursement. Recent changes to federal law make RHC designation for clinics in rural areas even more attractive. The applicable billing and coding rules, however, can be confusing. RHC reimbursement, billing, requirements, and designation were discussed during a PYA webinar, “Healthcare Regulatory Roundup: Rural Health Clinic Opportunities,” on February 21, 2024. PYA’s Martie Ross and Traci Waugh focused on several topics including: Services that qualify as an “RHC visit” reimbursable under the all-inclusive rate RHC reimbursement for telehealth services, care management services, communication technology-based services, vaccines, and non-RHC services RHC regulatory requirements and the process to receive RHC designation  This webinar was part of PYA’s twice-monthly Healthcare Regulatory Roundup (HCRR), a popular series during which PYA experts provide practical insights on the latest industry regulatory developments. Learn about PYA’s Center for Rural Health Advancement. If you would like assistance with rural health reimbursement, legislative or regulatory impacts, or any matter involving compliance, valuation, or strategy and transactions, one of our executive contacts would be happy to assist. You may email them or call (800) 270-9629.

Beginning this year, Medicare will make payment under the Physician Fee Schedule for HCPCS G2211, the outpatient intensity add-on code.  The impacts of the code were presented during a PYA webinar on February 7, 2024. During the webinar, a panel of PYA experts, including Lori Foley, Valerie Rock, Angie Caldwell, and Martie Ross, discussed the requirements for this new code and its financial impact on physician practices. Topics of discussion included: Services to which the add-on code applies Who can bill the code and in what circumstances What practices stand to lose if they don’t bill the add-on code Documentation Potential audit risk areas Approaches to implementation Potential impact on physician compensation formulas This webinar was part of PYA’s twice-monthly Healthcare Regulatory Roundup (HCRR), a popular series during which PYA experts provide practical insights on the latest industry regulatory developments. Watch for more HCRR webinars coming soon, and for updates about all of our webinars, check the PYA website and PYA’s LinkedIn page. If you would like assistance with legislative or regulatory impacts or any matter involving compliance, valuation, or strategy and transactions, one of our executive contacts would be happy to assist. You may email them below or call (800) 270-9629.

It’s not just Washington we have to monitor. State legislatures throughout the country also are grappling with a wide range of healthcare-related issues. Action taken in one state tends to influence how other states address these matters. The webinar, “Healthcare Regulatory Roundup: Coming to a Statehouse Near You”, held on January 24, 2024, addressed state-level influence on healthcare. PYA’s Martie Ross and Kathy Reep delved into hot topics in state capitols, including Medicaid coverage Provider taxes and supplemental payments Quality standards and staffing levels Price Transparency Surprise Billing Tax-exempt hospitals/community benefit State health plan provider networks and fee schedules Licensure

PYA’s Lori Foley and Martie Ross offered a last look at the 2024 Medicare Physician Fee Schedule Final Rule by providing a detailed examination of 2024 changes to the Merit-Based Incentive Payment System (MIPS) and the Medicare Shared Savings Program (MSSP) as well as new Medicare reimbursement to address social determinants of health (SDOH). The webinar took place on January 10, 2024.

During our webinar on November 29, PYA leaders Valerie Rock, Carine Leslie, Katie Croswell, and Miriam Murray took a deep dive into key regulations finalized in the MPFS for 2024. Webinar attendees learned about updates related to these topics and service areas: Conversion Factor Office/Outpatient Evaluation & Management (E/M) Visit Complexity Add On Code G2211 Split/Shared Visits Telehealth Virtual Supervision Remote Patient Monitoring Diabetes Programs Health-Related Social Needs Behavioral Health Watch the November 8 HCRR webinar to hear a higher-level discussion about the 2024 final rules. This webinar was part of PYA’s twice-monthly Healthcare Regulatory Roundup, a popular series during which PYA experts provide practical insights on the latest industry regulatory developments. If you would like assistance with anything related to the Medicare Physician Fee Schedule, the CY24 final rules, regulatory impacts, or any matter involving compliance, valuation, or strategy and transactions, our executive contacts would be happy to assist. You may email them below or call (800) 270-9629.

On October 27, CMS published the 2024 ESRD 2024 Final Rule. On November 1, the agency published the 2024 Home Health PPS Final Rule. On November 2, CMS published three final rules: the 2024 Medicare Physician Fee Schedule Final Rule, the 2024 OPPS Final Rule, and the OPPS Remedy for 340B-Acquired Drug Payment Policy for CYs 2018-2022 Final Rule. PYA Principal Martie Ross and Senior Manager Kathy Reep examined and discussed these rules. The webinar was held on November 8, 2023. This webinar was part of PYA’s twice-monthly Healthcare Regulatory Roundup, a popular series during which PYA experts provide practical insights on the latest industry regulatory developments. If you would like assistance with anything related to the CY24 final rules, regulatory impacts, or any matter involving compliance, valuation, or strategy and transactions, one of our executive contacts would be happy to assist. You may email them below or call (800) 270-9629.

PYA was pleased to host the second complimentary webinar in its new series, Healthcare Dealbreakers: What You Don’t Know Can Hurt You. Healthcare dealbreakers are rarely obvious; they lurk under the surface waiting to expose investors who fail to exercise appropriate caution. Each quarter, PYA executives share practical insights into some of the most complex dealbreakers in healthcare, helping investors and providers recognize the warning signs that signal trouble for a potential deal. Healthcare Dealbreakers: Avoiding Post-Acquisition Compliance Surprises How deep of a diligence review is necessary to mitigate future risk? What processes should you implement to identify and address risk quickly after acquisition? PYA Principals Valerie Rock and Kristen Davidson shared their experience with post-acquisition compliance surprises. They examined options for establishing auditing, monitoring, and internal controls to mitigate compliance and regulatory risks after closing a deal. Valerie and Kristen led webinar attendees through these objectives: Learning common compliance issues found during and after due diligence on physician practices and other healthcare providers Hearing lessons learned from post-acquisition compliance surprises Discussing best practices for auditing, monitoring, and internal controls after diligence, including how to incorporate pre-closing diligence findings The webinar took place on October 31, 2023.

PYA Principal Martie Ross and Senior Manager Kathy Reep addressed new proposed rules for the No Surprises Act, including changes to the rules around administrative fees. They also took a deep dive into new guidance that has been published by the agencies with regard to the No Surprises Act. ​​​​​​​ The webinar took place on October 25, 2023. This webinar is part of PYA’s twice-monthly “Healthcare Regulatory Roundup” series in which experts from across the firm provide practical insights on the latest regulatory developments. If you would like assistance with anything related to the No Surprises Act, regulatory impacts, or any matter involving compliance, valuation, or strategy and transactions, one of our executive contacts would be happy to assist. You may email them below or call (800) 270-9629.

Twice each month, PYA experts discuss the latest industry regulatory developments during our popular Healthcare Regulatory Roundup (HCRR) webinar series. In this webinar, we presented a review of the expansion of Medicare reimbursement for certain types of care. Over the last several years, the Centers for Medicare & Medicaid Services has expanded Medicare reimbursement for virtual care, including care management and remote monitoring services. During this one-hour webinar, PYA Principal Martie Ross discussed: Utilization of care management and remote monitoring services Medicare billing rules for care management and remote monitoring services Navigation of ambiguities in Medicare billing rules   Lessons learned from launching care management and remote monitoring programs

On September 28, PYA presented a complimentary webinar that closely examined community benefit reporting by tax-exempt hospitals. During the webinar, PYA Principal Debbie Ernsberger and Senior Manager Abigail Campbell discussed the history and trajectory of Schedule H and outlined best practices for compiling community benefit data. Webinar attendees gained an understanding of four senators’ concerns about reporting and learned to more accurately report their hospitals’ data. Specifically, Debbie and Abigail discussed these points: The history of Schedule H Schedule H stakeholders, including hospital associations and state legislative bodies The content of the August 2023 senators’ letter Best practices for compiling community benefit data and what you should be doing now