Social Media Ideas for Legal & Regulatory And Reimbursement

The Influence of Regulatory Requirements and Evolving Reimbursement Models on Health IT Strategy for Payers and Provider...

As with all healthcare topics, the topic of payers and providers is very complex and multifaceted. So today, we are going to narrow our focus down to regulatory requirements and ev...

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...

Approved but Underpaid: How Payers are Quietly Redrawing the Rules of Hospital Reimbursement

The following is a guest article by Missy Harbert, Senior Solution Advisor at Revecore For years, hospitals have built denial management programs around a predictable premise: when...

No Surprises Act Check-In: The Latest Changes to the IDR Process [Podcast]

In this episode, Gabe Scott, Kevin Alonso, and Cindy Laura Ortega Ramos unpack recent updates to the federal independent dispute resolution (IDR) process under the No Surprises Act...

Five Cases Health Care and Life Sciences GCs Should Keep Watching in 2026

In 2026, several federal cases are poised to shape regulatory risk, reimbursement, and False Claims Act exposure, as well as innovation pathways across the health care and life sci...

Manufacturer’s $2,500 Reimbursement Proposal for Device Failures

The Payment Integrity Reckoning

The following is a guest article by Mark Noel, SVP and GM of ClaimInsight at AMPS Why transparency and defensibility have become non-negotiable for health plans — and what it takes...

McDermott+ Check-Up: June 18, 2026

THIS WEEK’S DOSE Senate Democrats request information on reforming drug pricing. The request for information focuses on lowering prescription drug pricing and out-of-pocket costs...

State Regulation of PBMs Subject to Robust Legal Challenges

Medicaid Program Integrity on the Agenda

Under Pressure: Why Pre-Bill Prevention is Now Non-Negotiable in Coding and Denial Management

The following is a guest article by Ritesh Ramesh, CEO at MDaudit Healthcare organizations are operating in an environment defined by financial pressure, regulatory scrutiny, and r...

The Repricing of Legal and the $30M Cost Shift Playbook

Join us for a live panel with in-house legal leaders and experts sharing strategies to manage legal spend, align with Finance, and drive results.       

MedSpire Insight: Compliance Is Becoming a Competitive Advantage in Patient Acquisition

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

RAC Audit? Your Seven Next Steps

Recovery audit contractors (RAC) working for the Centers for Medicare and Medicaid Services (CMS) review providers’ program billings on a post-payment basis. As a result, RAC audit...

Health Provider News

NATIONAL After FDA commissioner departure, drug center head is out AHA Statement on House Health Subcommittee Hearing Examining Physician Fees, Payment Reforms AMA taps new COO fro...

Federal Agencies Finalize Long-Pending No Surprises Act IDR Operations Rule

Health Provider News

National 7 CMS rules and policy updates to know in 2026 Agencies issue proposed rule codifying Medicare Drug Price Negotiation Program AHA calls for improvements to FY 2027 payment...

<![CDATA[Regulatory Changes: Market Access Strategy Can No Longer Wait Until Launch ]]>

340B at a Crossroads: What Health Systems Need to Know About Senator Cassidy's Reform Proposal

On June 25, 2026, Senate HELP Committee Chairman Bill Cassidy (R-LA) released a sweeping legislative discussion draft titled the 340B Drug Pricing Integrity and Affordability for P...

Willy Wonka and WISeR: Did You Get a Golden Ticket?

Key Takeaways CMS is set to launch the WISeR gold-carding exemption program on July 6 in Washington state, with quarterly rollouts to the other five WISeR states to follow. Provid...

Mandatory Provider-Based Attestations Are Taking Shape: CMS Releases Proposed Implementation Framework

Earlier this year, Congress enacted Section 6225 of the Consolidated Appropriations Act, 2026 (“CAA”), establishing a new Medicare condition of payment for off-campus hospital outp...

<![CDATA[What Does the Regulatory Landscape Look Like From the Other Side of FDA?]]>

Post Acute Update: HHS-OIG Issues Unfavorable Advisory Opinion on Subscription-Based Referral Management Software

The U.S. Department of Health and Human Services Office of Inspector General (“OIG”) recently issued Advisory Opinion 26-15 addressing a subscription-based referral management soft...