The Latest

Democrats now control Congress. MGMA's Anders Gilberg on what that means for Medicare pay, the lame duck and the Patients First Act.

A five-year update from the National Academies warns that coverage losses will strain primary care practices.

New Medicare codes, billing rules and deadlines arrive in the next 14 months. Here's what to set up now.

A family physician argues clinical AI should earn independence task by task, the way medical trainees do, with a physician accountable at every stage.

Four in five medical groups have open admin jobs. Here's how to keep claims, denials and prior authorizations moving until you hire.

Patients can now link their charts to AI assistants. Here's how to adjust intake, results, scripts and documentation before they walk in.

Groups say the pay cuts need congressional action, remote monitoring staffing rules are delayed to 2029, and speech-language therapy billing changes Jan. 1.

Humana and athenahealth just took electronic prior authorization nationwide. Here's what to ask your own EHR vendor before payer APIs go live Jan. 1.

Neil Baum, MD, lays out five pre-visit planning steps that save time, cut follow-up calls and portal messages, and improve patient care.

Practices face a lower conversion factor and new billing rules on Jan. 1, while group visits, coaching and ACO options open other revenue paths, according to group reaction.

CMS’ latest rule will have practice-level effects next year. Here’s what to know to get ready.

Office 2021 and Windows 11 24H2 lost security fixes Oct. 13, and Windows Server 2016 is next. Here's where outdated tech hides in a practice.

The Fifth Circuit revived a Meta Pixel class action against Eyemart, finding IIHI covers far more than prescription data. Here's why it matters.

Practices face a 2.31% conversion factor cut, a 20% same-day visit reduction and new E/M modifiers starting Jan. 1.

Two Medicare fraud cases, one over Botox and one over COVID-19 test kits, map the chart and claims gaps practices should audit now.

Democrats won Congress, but the Jan. 1 Medicaid work rules still stand. Here's how to budget your 2027 payer mix around what changed and what didn't.

The federal checklist behind your EHR shrinks Dec. 28. Lock down your contract, MIPS reporting and referral workflows while you have leverage.

Medicare’s monthly bundled codes pay primary care for work between visits. Most practices have not tried them yet.

'Not covered' is now the top denial reason, and UnitedHealthcare's pediatric code lists don't match. Run these checks before Dec. 1.

The 2026-2027 respiratory season is just about here. There’s still time to vaccinate patients, experts say.

The 2nd and 5th circuits won't let providers sue over unpaid IDR awards. Here are the routes left and how to reserve for money that may never come.

WISeR cut targeted services 15 to 20 percent in six states. These fixes protect your volume, your claims and your patients' place in line.

Neil Baum, MD, offers physicians a simple ethics check: Could you comfortably explain your decision to a patient or colleague over coffee?

Premiums are climbing far faster than physician pay. Here's how independent practices can build the case for higher payer reimbursement rates.

Insurer exits and network splits will change Medicare Advantage coverage for many patients on Jan. 1. Here's how practice leaders can prepare in every state.

Pennsylvania's outbreak is part of a national surge. Here's how to prepare the front desk, exam rooms, staff records and vaccine supply.

A Johns Hopkins employee put 3,182 patients' data into a consumer AI tool. Here's what that mistake would cost a small practice.

Hurricane Isaias waivers add little on telehealth, but Medicare Advantage network rules and refill limits loosen for Florida practices.

Most partnership problems are predictable. Settle pay, governance, new partners and succession while the group is healthy, not after trouble starts.

MGMA poll: 63 percent of groups are adding revenue cycle automation as payers push harder, and the EHR is the first place to look.

Here’s how to make your front desk part of the state’s dengue response.