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OIG Report- $2.4B in Unallowable Trauma Activation Charges

Amy Bailey September 29, 2025

The Office of Inspector General (OIG) just released a critical audit revealing that 77% of trauma team activation claims submitted to Medicare between 2020 and 2022 did not meet federal

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2026 ICD-10 Coding Changes and Implementation Deadline – Are You Ready?

Amy Bailey August 25, 2025

The October 1st implementation date for the 2026 ICD-10-CMS and ICD-10-PCS changes are quickly approaching. Do you have an implementation plan? The updates bring both

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CMS Releases the 2026 Proposed OPPS Rule

Amy Bailey July 16, 2025

The Centers for Medicare & Medicaid Services (CMS) has released the CY 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Proposed

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CMS Releases the 2026 MPFS Proposed Rule

Amy Bailey July 15, 2025

The Centers for Medicare & Medicaid Services (CMS) has issued the CY 2026 Medicare PFS Proposed Rule (CMS-1832-P), and it brings major updates to payment

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CMS Issues Updated Price Transparency Guidance

Amy Bailey May 26, 2025

The Centers for Medicare & Medicaid Services (CMS) has issued “Updated Hospital Price Transparency Guidance” (May 22, 2025) which outlines new policies pursuant to Executive Order

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CMS Announces Plans to Conduct Significant Medicare Advantage Audits

Amy Bailey May 22, 2025

The Centers for Medicare & Medicaid Services (CMS) has announced a major expansion of its audits of Medicare Advantage (MA) plans. Effective immediately, CMS will

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