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Modern Healthcare Illustration / Getty Images With five months before the surprise billing ban takes effect, the Biden administration hasn t released many of the most important details about how the No Surprises Act will work, leaving providers and insurers little time to plan for the changes. CMS first rule outlawing balance billing contained expected patient protections against surprise billing and high cost-sharing for out-of-network care, as outlined in the December law. But providers and insurers are still in the dark about the independent dispute resolution process and how regulators will define key terms for arbitrators or calculate median in-network rates. It s not really what providers or payers were looking for, Avalere Health consultant Tim Epple said. I don t think there is anything that we ve seen that differed meaningfully from the legislative text or the intent of the statute. ....
Tennessee lawmakers this session have sought modest changes to the stateâs telehealth laws, adding capabilities for behavioral health and safety-net providers to leverage after health care regulations are put back into place post-pandemic. Gov. Bill Lee last week signed a bill sponsored by Sen. Todd Gardenhire (R-Chattanooga) and Rep. Iris Rudder (R-Winchester) that expands the point of care for behavioral health services to a patientâs home. The legislation effectively clears the way for insurance reimbursement for telehealth services that have in the past year and change benefited from a temporary reprieve in digital health regulations. Both chambers passed the bill with unanimous support from lawmakers and are now considering a separate piece of legislation that strips back state licensing laws for health care professionals providing services for free. ....
Share it Editor s note: This story is part of a series on the trends that will shape the industry in 2021. You can find all the articles on our trendline. For a look at the business trends affecting other industries, see the Dive Outlook on 2021. The coronavirus pandemic set in motion a cascade of changes in healthcare, and no sector was impacted more than digital health. The fledgling industry rapidly accelerated as COVID-19 changed technology helping patients receive care outside of the hospital or doctor s office into a necessity, instead of a luxury. That acceleration has continued into 2021, and could even increase this year, experts say, creating a sea change in healthcare delivery and operations. Global healthcare industry revenues are expected to exceed $2.6 trillion by 2025, up from $2 trillion last year, with the majority of that growth propelled by artificial intelligence and telehealth, according to consultancy Frost & Sullivan. ....