Changes will go into effect Jan. 1, 2027, and aim to improve care delivery and data for maternal health outcomes.

GREENSBORO, N.C. (WGHP) — North Carolina Attorney General Jeff Jackson announced on Tuesday that the state has reached a six-figure settlement in a Greensboro Medicaid fraud investigation. The United ...

Another top Republican lawmaker is floating plans to overhaul the Current Procedural Terminology, or CPT, code system. Rep. James Comer, R-Kentucky, who chairs the House Committee on Oversight and ...

John writes about the politics of health care, and he is the author of the twice-weekly D.C. Diagnosis newsletter. You can reach John on Signal at John_Wilkerson.07. WASHINGTON — For decades, ...

NEW YORK — The clinical lab industry is keeping a wary eye on the US Centers for Medicare & Medicaid Services (CMS) as the agency explores regulatory and statutory changes that it could use to crack ...

From CMS developments to device coverage, here are 10 payer updates spine surgeons should know headed into 2026: 1. Some fee-for-service spine procedures in traditional Medicare will have prior ...

The Centers for Medicare & Medicaid Services (CMS) on Friday finalized its annual physician fee schedule for 2026, giving doctors treating Medicare patients a 3.77% pay bump if participating in ...

This article is the latest in the Health Affairs Forefront featured topic, “Health Policy at a Crossroads,” produced with the support of the Commonwealth Fund and the Robert Wood Johnson Foundation.

In early 2024, one of our clients, a specialty clinic in the Midwest, discovered it had unknowingly failed to submit over 6,000 claims due to a silent software integration failure. The result: nearly ...

Alli Oakes, executive director of research at Trilliant Health, shared that upcoding is a “prime example” of healthcare waste—where visits are billed at increasing levels of intensity without clinical ...