Social Media Ideas for Legal & Regulatory And Reimbursement

Big Law Redefined: Digital Health Miniseries Episode 2 | Regulatory Strategy and Reimbursement Essentials for Digital He...

The Influence of Regulatory Changes and Evolving Payer Requirements on RCM Technology Strategy and System Selection

Life is ever-changing and complex. This means that the regulations and requirements we’ve made previously cannot be permanent. They need to be updated regularly to match the curren...

The Remote Monitoring Reckoning: What CMS’s CY 2027 Proposed Rule Means for Providers and Vendors

Medicare’s reimbursement of remote patient monitoring services, beginning in 2019, offered a meaningful patient care opportunity, paying to give patients devices to measure their h...

Pharmacy Benefit Operations Infrastructure Must Rise to Regulatory Reform Standards

The PBM reform efforts are directional, not temporary. Meeting these expectations requires automated systems that can reconstruct claim logic on demand and provide real-time alignm...

340B Rebates 2.0- HRSA Revives Its Pilot Program — and Sets Up a Collision Course With Congress

The Trump administration advances a claims-based rebate model for select 340B drugs as a new bipartisan Senate bill would block it, forcing health systems to track three reform pat...

FQHCs - The Expanding Landscape of Medicare Billing Outside of PPS for Care Management Services

Summary: Medicare has steadily expanded the services that Federally Qualified Health Centers can bill outside the Prospective Payment System, creating new reimbursement opportunit...

5-Steps to Prepare for CMS’s 2027 Insidious Campaign to Cut Orthopedic and Spine Reimbursement

Red Alert. CMS is cutting reimbursement for orthopedic and spine surgeries. Details are in the fine print.

Mainstay Medical Announces Positive Coverage Decision for ReActiv8В® from Highmark Inc.

Mainstay Medical today announced that Highmark Inc. has established favorable coverage for its ReActiv8 Restorative Neurostimulation therapy.

2027 OPPS: The 5 Provisions Health Systems Should Be Evaluating

CMS published its 2027 Outpatient Prospective Payment System proposed rule last month. Most health systems are treating it as a routine reimbursement update. It deserves more atten...

Client Alert: A New Era for Maternity Billing—The Current Procedural Terminology Code Overhaul Reshaping Obstetric Reimb...

No Surprises Act Enters a New Phase: What Employers and Group Health Plans Need to Know About the 2026 IDR Rules

Highlights New Independent Dispute Resolution (IDR) procedures are taking effect. The 2026 regulations standardize claim communications, restructure open negotiation, clarify b...

What Healthcare Organizations Miss When It Comes to Reimbursement Accuracy

At the end of the day, the most important question is a simple one: Do you actually know if you’re being reimbursed correctly? The post What Healthcare Organizations Miss When It C...

CMS, FDA Propose RAPID Pathway for Medicare Coverage of Certain Medical Devices

Key Takeaways The proposed RAPID pathway would create a new voluntary CMS/FDA process for certain innovative medical devices, with the stated goals of expediting Medicare coverage...

Medicare, Medicaid, and Reverification: What Patient Support Programs Need to Know Before January 2027

Today's guest post comes from Bryce Aronson, Director of Business Development at AssistRx. Bryce covers three considerations taking effect in January 2027—the end of Medicare P...

Bundle Up: CMS Mandates TJR Reimbursement Bundling Nationwide

CMS announced that the pilot test of bundling musculoskeletal reimbursement is going nationwide.

HRSA Announces Revised 340B Rebate Model Pilot Program for 2027

On July 31, 2026, the Health Resources and Services Administration (“HRSA”) announced a revised 340B Rebate Model Pilot Program (“2026 Pilot”) to provide a rebate mechanism through...

Wound Care Fraud: Attorney Insights for Providers and Businesses At Risk of Facing Federal Scrutiny

The U.S. Department of Justice (DOJ) and U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) are targeting healthcare professionals and others suspec...

Informa Connect’s Medicaid Drug Rebate Program Summit

Informa Connect’s Medicaid Drug Rebate Program Summit October 5-7, 2026 | Chicago, IL Drug Channels readers save 10% with code 26DRCH10* View Agenda | Download Brochure The Med...

Health Provider News

NATIONAL CMS Medicaid fraud unit flags 50 providers, $203M in payments CMS’ proposed remote patient monitoring ban, explained D.C. appeals court sides with HHS in 340B drug discoun...

More Than a Billing Requirement: CMS Turns Medicare Enrollment into a Program-Integrity Tool

Key Updates CMS has proposed a significant expansion of its Medicare provider enrollment and program-integrity authorities through the Calendar Year 2027 Home Health Prospective P...

Compliance Program Lessons from the Complete Health Settlement

On August 4, 2026, the United States Department of Justice (“DOJ”) on behalf of the Office of Inspector General (“OIG”) of the U.S. Department of Health and Human Services announce...

INFUSE Bone Graft for TLIF receives eligibility for Medicare New Technology Add-on Payment, Advancing Reimbursement Supp...

Medtronic announced that the CMS has granted a New Technology Add-on Payment (NTAP) for INFUSEâ„¢ Bone Graft for TLIF, effective October 1, 2026.

From Static Content to Living Compliance: The Next Era of Regulated Content in Life Sciences

Every week, commercial and medical affairs teams face an agonizing reality: millions of dollars and hundreds of hours are spent creating regulated content, only for it to stall in...

CMS's Revised Medicare Overpayment Rule: What Healthcare Providers Need to Know