Policy

MGMA is pushing back on any delay as insurers describe a three-step build.

MGMA's government affairs team walked through the fee schedule, MIPS, value-based care, Medicaid, Medicare Advantage and the year-end spending fight.

Florida's proposed school vaccine rule also rewrites DH 680, DH 681 and the Florida SHOTS forms and provider agreements.

Wisconsin APRNs can now apply to practice without a collaborating physician, but Medicare billing rules may still require one.

A delay would leave practices without the information they need to train staff and test workflows before the deadline, the AMA told CMS.

A House hearing put the Patients First Act and four related bills in play. Here is how each would change Medicare pay and practice rules.

Medicaid work requirements hit the front desk Jan. 1, 2027. What changes at check-in, in billing and when coverage lapses mid-treatment.

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.

The insurer pledge on prior authorization carried no enforcement. The federal rule arriving Jan. 1, 2027 does, and it lands on payers, on EHR vendors and, through a new attestation measure, on practices themselves.

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.