Today’s update touches on a number of healthcare news stories we are seeing at the federal level.
Taking lessons learned from the COVID-19 pandemic, the Biden Administration unveiled the strategy the U.S. has planned to prevent (and, if necessary, respond) to global biological threats over the next five years.
The strategy sets out three goals to guide the United States affirmative agenda to advance global health security:
In other news, a recent blog post from the American Hospital Association (AHA) critiqued the national discussion on healthcare price transparency. The post argues that although hospitals report more transparency data than other healthcare entities, calling upon hospitals to release even more data will not “solve the pressing issues” that face the healthcare industry. The blog post argued that existing hospital reporting is extremely costly, time-consuming, and ever-changing and that commercial insurers and drug companies are not held to the same data reporting standards.
In other news, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra spoke at a Senate hearing and urged states to expand Medicaid to improve rural health outcomes. Becerra stated that HHS is doing what it can, so women get good care before delivery, during delivery, and after delivery. Becerra also emphasized the need to ensure the agency’s COVID-19 telehealth flexibilities continue.
Relatedly, Mississippi Senator Cindy Hyde-Smith also expressed concerns about maternal care deserts caused by hospital closures in her state at the same Senate hearing last week. Senator Smith noted that Mississippi experiences some of the worst maternal health outcomes in the country and often leads the country in infant mortality.
Finally, a recently published study in Health Affairs Scholar reports that telehealth remains underused, and remote patient care is either rarely billed to Medicare or rarely occurs. For example, in 2020, e-visits accounted for just under 1 percent of all managed service codes submitted to Medicare at the height of the pandemic, which later fell to half a percent in 2021 and 2022. The study reports that overall, telehealth remains underutilized, and claims its findings can help alleviate concerns regarding the potential overuse of portal messages and e-visit billing.
The 2026 Medicare Physician Schedule Final Rule includes several distinct policy changes in which the Centers for Medicare & Medicaid Services (CMS) modifies how it
As discussed in my prior articles, Medicare Advantage (MA) organization payments incorporate a beneficiary’s health risk, as determined by diagnoses that map to Centers for
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Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.
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Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY26 IPPS, including new ICD-10-CM/PCS codes, CCs/MCCs, and MS-DRGs, plus insights, analysis and answers to your questions from two of the country’s most respected subject matter experts.
Get clear, practical answers to Medicare’s most confusing regulations. Join Dr. Ronald Hirsch as he breaks down real-world compliance challenges and shares guidance your team can apply right away.
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.
Learn how to navigate the proposed elimination of the Inpatient-Only list. Gain strategies to assess admission status, avoid denials, protect compliance, and address impacts across Medicare and non-Medicare payors. Essential insights for hospitals.
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