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CMS has prevented more than $1.6 billion in potentially fraudulent Medicare laboratory payments through provider revocations, payment suspensions, overpayment recoveries, and law enforcement referrals. The enforcement effort uses AI-powered analytics

CMS has released the CY 2027 Medicare Physician Fee Schedule proposed rule, outlining major physician payment changes effective January 1, 2027. The rule includes lower conversion factors, proposed E/M complexity

A new AMA survey finds that only one in three physicians believe insurer prior authorization reform pledges will create meaningful change. Physicians continue to report care delays, rising denials, inconsistent

HRSA has announced nearly $140 million in new funding to improve health in rural communities, supporting substance use prevention and recovery, rural medical residency programs, provider network sustainability, and telehealth

EHR adoption among U.S. non-federal acute care hospitals has reached near-universal levels, with more than 99% using certified EHR systems by 2024. With implementation now widespread, healthcare organizations are shifting

HHS and ONC have announced new steps to strengthen the TEFCA network as health records exchanged through the nationwide framework surpass one billion. The expansion increases focus on secure health

CMS has proposed major Medicare reforms aimed at expanding accountable care participation, modernizing physician payment, reducing administrative burden, and shifting incentives from reactive sick care toward proactive prevention. The proposal

CMS has finalized a new rule to strengthen oversight of Accrediting Organizations responsible for evaluating Medicare-certified healthcare providers and suppliers. The rule aligns AO standards with Medicare requirements, requires unannounced

CMS has released a nationwide framework to implement Medicaid work requirements for certain adults ages 19 to 64, requiring 80 hours per month of qualifying activities such as employment, education,

CMS has proposed sweeping limits on Medicaid state directed payments, aiming to align reimbursement rates with Medicare benchmarks and reduce federal spending. The proposed rule could significantly affect hospitals, providers,