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Leaders in Medical Billing

May 7, 2024

In this insightful episode of the Leaders in Medical Billing podcast, host Chanie Gluck talks with Matt Riter, Principal at Capitol Associates, about key changes in healthcare legislation affecting the revenue cycle management (RCM) industry. They delve into critical provisions of the No Surprises Act and the challenges arising from recent cyberattacks affecting healthcare providers.


Key Topics Covered:


  1. Change Healthcare Cyberattack (02:15):
    Matt provides an overview of the Change Healthcare cyberattack, its impact on UnitedHealthcare services, and the challenges faced by providers in accessing payment and data.

  2. No Surprises Act Updates (18:45):
    Discusses the Advanced Explanation of Benefits (AEOB) and Good Faith Estimate (GFE) provisions, emphasizing the importance of preventing surprise medical bills and promoting transparency.

  3. Medicare Reimbursement Challenges (32:20):
    Insights into the complexities of Medicare reimbursement, upcoming payment cuts, and how providers are affected by shifting policies.

  4. Legislation & Advocacy (45:30):
    Matt discusses pending bills in Congress addressing payment issues, virtual credit card fees, and EFT charges to support healthcare providers.

  5. FTC Antitrust Investigation (58:10):
    An analysis of the Federal Trade Commission’s investigation into UnitedHealthcare’s market dominance and the implications for the healthcare sector.


Below you will find the bills referenced in the episode

H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which permanently ties annual Medicare reimbursement updates to MEI.


H.R. 6371, the Provider Reimbursement Stability Act of 2023, which reforms how CMS budget neutrality adjustments are calculated.


H.R.6487/S.3805, the No Fees for EFTs Act, which closes the loophole that payment vendors exploit to charge EFT transaction fees.