Policy

The comment window closes Sept. 14, and the same rule already previews what a coding transition looks like operationally.

Recent changes to medical laws in the Land of Lincoln.

A year after the insurer pledge, DrFirst CMO Colin Banas grades the six promises and names the Jan. 1, 2027 breaking point.

Jay Bregman of Andel explains how employers are carving high-cost drugs out of the pharmacy benefit, and what happens to a patient's price when the contribution stops.

Dozens of insurers promised six fixes to prior authorization. A year in, physicians report almost no change, and the harder test arrives Jan. 1, 2027.

Joanne Frederick of Government Market Strategies argues the fix for runaway health care costs turned out worse than the problem it solved.

An outbreak in the news brings a surge of calls before it brings a surge of cases. A Michigan pediatrician on the triage rule, the lab conversation and the reassurance approach that keep a practice from being overwhelmed.

MGMA's Anders Gilberg on the 1.68% conversion factor cut, budget neutrality winners and losers, and why MVPs worry him.

The proposed 2027 Medicare fee schedule shifts payment between specialties and changes same-day billing as MIPS winds down, and MGMA's Anders Gilberg explains what practice leaders should watch before comments close Sept. 14.

MGMA's Anders Gilberg says the cuts land hardest on independent groups, calls MVPs 'MIPS on steroids' and expects any fix to wait for a lame duck Congress.

The same low-risk procedure can pay five to 12 times more in a hospital outpatient department than in a physician's office. Three U.S. Women's Health Alliance advocates break down what that gap does to recruiting, referrals and patient choice, and the federal bill aimed at closing it.

A new federal rule makes it far cheaper for practices to challenge denied and reduced payments, but Anders Gilberg of MGMA says the harder problem is getting insurers to pay up after physicians win.

MGMA's government affairs team on what’s already changed in 2026 and what’s still to come.

Carlos Cardenas, M.D., explains why a CMS request for information may be the biggest opening for physician-owned hospitals since the ACA.

As House lawmakers take up MACRA, MGMA backs three bills to tie payments to inflation, raise budget neutrality and replace MIPS scoring.

GeoVax CEO David Dodd says the U.S. vaccine system isn't broken, but it badly needs better communication, clearer processes and more listening.

Reps. Miller-Meeks, M.D., and Conaway Jr., M.D., introduce legislation to reform the Medicare Physician Payment System.

A long-awaited HIPAA Security Rule update could arrive this month, and medical practices should start preparing now.

Four experts unpack a landmark report showing investment in primary care is the most powerful cost-reduction strategy the U.S. isn't using.

Bipartisan legislation targeting Medicare Advantage prior authorization has rare supermajority support.

Private equity has drawn increasing scrutiny in health care, but responsible investment paired with strong compliance infrastructure can strengthen rather than destabilize the system.

Medicare could run out of money by 2033 and physicians could end up paying the price.

MGMA's Anders Gilberg joins the show to break down the group's new regulatory burden report.

95% of practices say regulatory burden has grown over the past three years, according to MGMA's 2026 Regulatory Burden Report.

Rep. Greg Landsman (D-Ohio) explains why he wants to ban the WISeR model, and why AI should be used to fix prior authorization, not make it worse.