6 Key Healthcare Policy Changes to Know for 2025 and Beyond
1. Payment & Reimbursement Changes For Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) site-neutral payments, the Centers for Medicare & Medicaid
1. Payment & Reimbursement Changes For Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) site-neutral payments, the Centers for Medicare & Medicaid
The Proposed Rule on the Medicare Physician Fee Schedule (MPFS) for the 2026 fiscal year is out, and if adopted, it’s got very good news
Because so many investigations are trigged by situations where people think a violation of company policy is a violation of the law, I want to
Sorting through strident but contradictory opinions can be challenging. Last week, I explained why many new problems for an established patient can be treated as
A peachick has hatched! My daughter Madison loves the little peachick. He or she is thriving, and has imprinted on Madison. Follows her everywhere. Speaking
The Centers for Medicare & Medicaid Services (CMS) issued its Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Proposed Rule for the 2026
During a week in which headlines seized on a U.S. Supreme Court decision paving the way for thousands of layoffs of federal health workers, a
Today I want to provide some clarifications to a couple of things I recently read. Now, I must say that correcting others is often viewed
From think tanks to federal agencies, health policy in the U.S. is often shaped by voices we don’t always see in the headlines. Abe Sutton,
According to the American Hospital Association (AHA), Medicare reimbursed hospitals at just 82 percent of the cost of care in 2022, meaning hospitals absorbed an
Today I have a few newsworthy items for you. First, Medicare updated one of the Manuals with information on billing for patients who are in
I think it is important to challenge one portion of an article that was widely distributed two weeks ago. The article included a statement that,

Federal auditors are intensifying their focus on inpatient psychiatric facilities, using advanced data analytics to spotlight outliers and pursue high‑dollar repayments. In this high‑impact webcast, Michael Calahan, PA, MBA, Compliance Officer and V.P., Hospital & Physician Compliance, breaks down what regulators are really targeting in IPF-PPS admissions, documentation, treatment and discharge planning. Attendees will learn practical steps to tighten processes, avoid common audit triggers and protect reimbursement and reduce the risk of multimillion-dollar repayment demands.

In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.

Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.

Stay ahead of the 2026-2027 audit surge with “Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue,” a high-impact webcast led by Michael Calahan, PA, MBA. This concise session gives hospitals and physicians clear insight into the most likely federal audit targets, such as E/M services, split/shared and critical care, observation and admissions, device credits, and Two-Midnight Rule changes, and shows how to tighten documentation, coding, and internal processes to reduce denials, recoupments, and penalties. Attendees walk away with practical best practices to protect revenue, strengthen compliance, and better prepare their teams for inevitable audits.

Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Sherri L. Clayton, RHIT, CSS. You’ll learn how to apply global maternity package rules accurately, select the right CPT codes for procedures and visits, and identify documentation gaps that lead to denials. With practical guidance and real examples, this session helps you strengthen compliance, reduce audit risk, and ensure accurate reimbursement for women’s health services.

Uncover essential coding insights with nationally recognized coding authority Kay Piper, RHIA, CDIP, CCS. Through ICD10monitor’s interactive, on‑demand webcast series, Kay walks you through the AHA’s 2026 ICD‑10‑CM/PCS Quarterly Coding Clinics, translating each update into practical, easy‑to‑apply guidance designed to sharpen precision, ensure compliance, and strengthen day‑to‑day decision‑making. Available shortly after each official release.

Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.

Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s third quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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