Transparency & the TMA Suit: Major Updates
Cate Brantley, JD
June 11, 2025
It has been a few weeks since my last legislative update, and while quite a bit has happened during the interim, I’m going to brief
It has been a few weeks since my last legislative update, and while quite a bit has happened during the interim, I’m going to brief
Price transparency in healthcare has long been a stated priority for the Trump Administration, both the first and second, and several recent public moves have
Given that they share similar names and themes, it is easy to conflate Price Transparency and the No Surprises Act, but while they are both
The recent Republican budget proposal has sparked heated debate over its projected impact on Medicaid, with Democrats arguing it cuts as much as $880 billion
In a significant overhaul of Medicare Part D, set to take effect in 2025, beneficiaries are poised to experience a transformative change in how prescription
Federal officials this week announced the rollout of a Final Rule for Medicare Part D prescription drug plans and the rapidly expanding Medicare Advantage (MA)
In the realm of healthcare, the ideal of transparency has long been a beacon of trust and accountability. However, the journey towards price transparency in
Centers for Medicare & Medicaid Services (CMS) enforcement of new price transparency rules began in January, and ClaraPrice, which provides consulting services to hospital IT,
The increasing and often unaffordable cost of prescription drugs in this country is a near-constant topic of discussion within the healthcare industry. The Biden Administration
In light of Medicare finally forcing big pharma to do what it has to do and negotiate drug prices, I want to talk about a
If you work for a hospital, please read this article closely. If you’re at any other type of healthcare entity, the price transparency rules don’t
As much as I love a state fair, it isn’t something I write about very often, because usually, the primary risk one would associate with
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 Stacey Shillito, CDIP, CPMA, CCS, CCS‑P, CPEDC, COPC. 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.
BLOOM INTO SAVINGS! Get 25% OFF during our spring sale through March 27. Use code SPRING26 at checkout to claim this offer.
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
