2+ hour, 40+ min ago  (751+ words) For MRFs,[3] the Departments focuses on: Reporting of Product type" " New " The Departments also propose to add a requirement for plans and issuers to report the product type (e.g., Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO)) associated with the…...

4+ hour, 43+ min ago  (153+ words) Section 6225 of the Consolidated Appropriations Act of 2026 (CAA 2026), enacted on February 3, 2026, fundamentally changes Medicare's treatment of hospital off-campus provider-based departments. CAA 2026 eliminates that discretion. Attestations will no longer be optional compliance tools; they become statutory prerequisites to Medicare payment. Likewise,…...

8+ hour, 3+ min ago  (240+ words) They break down how to respond to audits, when to See'more'+ What should you do when an audit letter lands on your desk? Should you review records before sending them? What happens if you disagree with the results or owe…...

2+ day, 4+ hour ago  (687+ words) The Centers for Medicare & Medicaid Services (CMS) are required to update and publish payment policies and rates for hospital outpatient departments and ambulatory surgery centers (ASCs) annually." In November 2025, CMS released their "final rule" which details changes to payment policies…...

1+ week, 1+ hour ago  (505+ words) Many healthcare programs are extended for specific time periods, some as short as one or two years, others as long as 10. These "extenders" are usually attached to a larger piece of must-pass legislation....By: McDermott+ Healthcare Extenders Tracker (February 2026 Update)…...

1+ week, 4+ hour ago  (1105+ words) On February 2, 2026, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued its long-anticipated Industry Segment-Specific Compliance Program Guidance (ICPG) for the Medicare Advantage (MA) program " OIG's first MA-specific guidance since 1999....By: Goodwin OIG's Latest Guidance…...

1+ week, 22+ hour ago  (883+ words) Introduction and Summary - As part of the Consolidated Appropriations Act, Congress established new identification and attestation requirements for off-campus outpatient departments of acute care hospitals. Although Medicare requires that all off-campus outpatient departments billing for outpatient hospital services satisfy the…...

1+ week, 1+ day ago  (69+ words) On Feb. 3, 2026, President Donald Trump signed into law the Consolidated Appropriations Act, 2026 (CAA 2026), a sweeping piece of legislation including provisions that will substantially impact employer-sponsored health plans. Among other items, CAA 2026 tackles pharmacy benefit manager (PBM) drug pricing practices and…...

1+ week, 2+ day ago  (762+ words) On January 26, 2026, CMS released its Advance Notice of Methodological Changes for Calendar Year (CY) 2027 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (Advance Notice). The Advance Notice, which CMS releases annually, includes proposals for…...

1+ week, 2+ day ago  (917+ words) Key Takeaways - OIG's new Medicare Advantage Industry Segment-Specific Compliance Program Guidance (MA ICPG) highlights major compliance risk areas and provides practical guidance for MA plans and other parties....By: Polsinelli OIG's New Medicare Advantage Program Compliance Guidance: What Providers Need…...