News
Federal Legislative Update: Momentum Builds Around Medicare Site-Neutral Payment Policies
14+ hour, 20+ min ago (260+ words) Washington policymakers are increasingly aligned around expanding Medicare "site-neutral" payment policies in 2026, a shift that would pay hospital outpatient departments the same rates as physician offices for a broader set of common services. In November, CMS finalized a policy to…...
Counting the Days: Fifth Circuit Reverses Texas Hospitals’ DSH Rule Challenge
2+ day, 22+ hour ago (249+ words) The US Court of Appeals for the Fifth Circuit on December 9, 2025 reversed and remanded a decision from the US District Court for the Northern District of Texas that had vacated a 2023 federal regulation that threatened to reduce supplemental payments for…...
Application Window Opens Soon for CMS ACCESS Model Expanding Technology-Supported Care Options for Traditional Medicare
6+ day, 31+ min ago (209+ words) Unlike many other CMS Innovation Center models, the ACCESS Model will use voluntary, prospective alignment'meaning that patients with "Original" or fee-for-service ("FFS") Medicare will be able to choose to enroll in the Model directly through an ACCESS Participant or be…...
Why 2026 Medicare Advantage Performance Still Rises or Falls on Core Clinical Interventions
6+ day, 1+ hour ago (896+ words) The Landscape for Medicare Advantage (MA) quality, as we know is ever evolving, particularly in light of the just released Contract Year (CY) 2027 Proposed Rule. The proposal, as currently written, proposes major changes to Star Ratings and the ongoing integration…...
CMS’s MAHA ELEVATE Model: Integrating Whole‑Person Care into Original Medicare | Epstein Becker & Green - JDSupra
6+ day, 23+ hour ago (231+ words) The Make America Healthy Again: Enhancing Lifestyle and Evaluating Value'Based Approaches Through Evidence (MAHA ELEVATE) Model is a new federal initiative focused on expanding access to preventive and lifestyle-based care options within Original Medicare. The prevalence of chronic disease in…...
2026 Medicare Physician Fee Schedule
1+ week, 22+ hour ago (135+ words) The final Medicare Physician Fee Schedule for 2026 has now taken effect. Under the new rule, Center for Medicare Services (CMS) finalized two separate Medicare conversion factors depending on participation in a qualifying Alternative Payment Model (APM)....By: Tucker Arensberg, P.C. 2026 Medicare…...
HIPAA Notice of Privacy Practices Refresh for Self-Insured Group Health Plans: What to Change Before February 16, 2026
1+ week, 1+ day ago (390+ words) This post focuses on what plan sponsors should do now to prepare their HIPAA NPPs for February 2026what to add, revise, and remove. Since fully insured group health plans are not subject to the requirements discussed in this post, references to…...
New Year’s Resolution – Healthcare Compliance Program Checkup
1+ week, 1+ day ago (75+ words) For years, the government has been touting the importance of healthcare organizations having an "effective" healthcare compliance program. The U.S. Department of Justice (DOJ) has issued a 25-page document on what it expects to see when prosecutors evaluate the effectiveness of…...
Client Alert: HIPAA Enforcement Risks and Mitigation Strategies: Summary of Recent Office for Civil Rights Actions
1+ week, 2+ day ago (71+ words) This summary highlights recent 2025 Health Insurance Portability and Accountability Act (HIPAA) enforcement actions by the U.S. Department of Health and Human Services' (HHS) Office for Civil Rights (OCR), the risks they underscore for health care organizations and business associates, and practical…...
Practical Tips for Avoiding Common Mistakes with the 855 Medicare Enrollment Form
2+ week, 1+ day ago (426+ words) Why the 855 Form Deserves Your Attention While the 855 form may seem like an administrative chore, it is the gateway to Medicare reimbursement. Mistakes or delays in updating your enrollment record can lead to a stay or enrollment, deactivation, or other…...