While President-elect Trump’s pick for U.S. Department of Health and Human Services (HHS) Secretary, Robert F. Kennedy, Jr., put the agency in even international newspapers this week, the department governing public health and healthcare quality quietly had two notable reports attached to it that highlight a pair of issues it is responsible for that are likely to be found in the spotlight through the next few years.
The HHS Office of Inspector General (OIG) published a report last week examining how well hospitals are complying with price transparency requirements – or, as the results showed, how few hospitals are actually complying. OIG stated that the agency conducted the audit because it believes a lack of transparency and compliance with the 2021 final rule is to blame for the projected jump in healthcare spending in the future.
The report cites a Centers for Medicare & Medicaid Services (CMS) projection that healthcare spending is on track to account for 20 percent of the American economy by 2027. It also noted that Congress and the media have expressed concern over an apparent lack of compliance with transparency rules.
A total of 100 hospitals were randomly selected, and 37 of them did not comply with federal law. A total of 34 failed to comply with a requirement related to machine-readable files (MRFs), while 14 failed to comply with a requirement related to displaying shoppable services. OIG estimates that almost half of the 5,900 hospitals nationwide that are required to comply with the final rule do not, in fact, comply with requirements related to publicly displaying standard charges.
The report suggests that hospital staff believe that this lack of enforcement is due to confusion or uncertainty about specific requirements, limited resources, and a lack of assistance from CMS. And indeed, the report indicates that CMS’s enforcement mechanisms are not sufficient to ensure compliance. CMS officials apparently agreed, citing staffing issues. However, the report found that CMS has made strides this year and last in reviewing higher numbers of hospitals, assigning additional staff to reviews, and imposing civil penalties on noncompliant hospitals, and the agency cited improved rulemaking regarding the standardization of MRFs that should also shore up its enforcement power.
The report ended with a few recommendations on the issue, and while any incoming president and administration often rolls back certain policies and regulations when they take over, it is unlikely that the Trump Administration will stop or slow price transparency or other consumer-centric healthcare policies. The original transparency regulations, in fact, were published and subsequently defended in court under his first administration, so it is likely that another Trump administration will continue the support and enforcement of these and similar policies.
In another report, the U.S. Government Accountability Office (GAO) said that HHS is not meeting the mark when it comes to leading the charge on healthcare cybersecurity. Noting the dramatic increase in healthcare cybersecurity incidents over the last few years, the report highlighted the “challenges” HHS has faced in implementing cybersecurity initiatives to mitigate risk and collaborate with other government agencies on improving practices.
This includes several areas in which the agency reportedly falls short: not adequately monitoring the healthcare sector’s implementation of ransomware mitigation practices, not evaluating how effective its support (which comes in the form of documents, trainings, and threat briefings) is to the sector, and not coordinating properly with other cybersecurity-focused groups, agencies, and the states.
This report also ended with recommendations for HHS, suggesting that the agency determine how well the healthcare sector is adopting ransomware risk reduction strategies, evaluate which types of support are most effective to the sector, and coordinate with other agencies and states to make sure policies and requirements are consistent across the healthcare sector, as opposed to patchworked.
We also expect that the new Congress and the Trump Administration will likely continue to focus on cybersecurity in the healthcare space. We expect that that focus will be both inward-facing, at what the government should be doing, and externally, at how the commercial healthcare space can shore up its cyber defenses.
As the federal government shutdown drags on, an alarming message began circulating across the healthcare community: “physicians won’t get paid until the government reopens.” The
Among the many responsibilities of hospital case managers, none is more critical or more impactful than the initial discharge planning evaluation. Often referred to as
Please log in to your account to comment on this article.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY26 IPPS, including new ICD-10-CM/PCS codes, CCs/MCCs, and MS-DRGs, plus insights, analysis and answers to your questions from two of the country’s most respected subject matter experts.
This third session in our 2026 IPPS Masterclass will feature a review of FY26 changes to the MS-DRG methodology and new technology add-on payments (NTAPs), presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.
Learn how to navigate the proposed elimination of the Inpatient-Only list. Gain strategies to assess admission status, avoid denials, protect compliance, and address impacts across Medicare and non-Medicare payors. Essential insights for hospitals.
RACmonitor is proud to welcome back Dr. Ronald Hirsch, one of his most requested webcasts. In this highly anticipated session, Dr. Hirsch will break down the complex Two Midnight Rule Medicare regulations, translating them into clear, actionable guidance. He’ll walk you through the basics of the rule, offer expert interpretation, and apply the rule to real-world clinical scenarios—so you leave with greater clarity, confidence, and the tools to ensure compliance.
Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
