2026 IPPS and LTCH PPS Final Rule: What Hospitals Need to Know
The Centers for Medicare & Medicaid Services released the Fiscal Year 2026 Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System Final Rule on August 1. Taking effect October 1, 2025, the rule carries significant implications for providers, coders, administrators, and financial leaders.
Risk Adjustment Data Validation (RADV) Audits: Turning Compliance into Competitive Advantage
In this article we break down what makes Risk Adjustment Data Validation (RADV) audits so challenging, what’s changing, and how health plans can flip the script from reactive compliance to proactive strategy.
Healthcare Policy Changes in 2025 and Beyond: What Providers Need to Know to Stay Ahead
The healthcare policy landscape in 2025 is transforming, affecting reimbursement models, telehealth expansion, and patient access rights. For providers, staying informed and proactive is not options - it's essential for financial stability and regulatory compliance.
New CMS Payment Rates for 2025–2026 Flu Season: What Providers Need to Know
On August 13, 2025, the Centers for Medicare & Medicaid Services (CMS) released the updated Medicare Part B payment allowance limits for the 2025–2026 influenza (flu) season. These rates are effective August 1, 2025, through July 31, 2026 and reflect important changes that providers need to account for in their billing processes.
Staying Compliant: A Deep Dive into CMS Q4 2025 HCPCS Code Changes
On August 21, 2025, the Centers for Medicare & Medicaid Services (CMS) released its fourth quarter update to the HCPCS Level II code set. This update impacts a wide range of healthcare providers who report services, supplies, drugs, and equipment. (2).webp)