Regulatory Issues

2023 Preview Period for Doctors and Clinicians Is Reopening

CMS is reopening the Preview Period because 17 additional QPP performance measures were recently identified to be included in the CY 2023 QPP public reporting information. CMS also made additional updates and display corrections to the CY 2023 QPP performance data available during the Preview Period that closed in June.


CMS 2026 Proposed Rule for OPPS and ASC

On July 15, 2025, CMS issued a proposed rule that proposes updates to Medicare payment policies and rates for hospital outpatient and Ambulatory Surgical Center services under the Hospital Outpatient Prospective Payment System and ASC Payment System Proposed Rule for calendar year 2026.


CMS Penalties for Directory Errors Loom for Payors

By David Van Houtte – With a recent increase in rules and regulations from CMS, health plans are feeling the pressure of more scrutiny, and the fear of penalties looms. For example, the No Surprises Act, passed in 2022, has already resulted in healthcare facilities, payors, and providers paying more than $11 million in penalties.






Socialcare on FHIR over Direct

By Brian D. Handspicker – This post builds upon a recent blog by Lisa Nelson, Fractional Chief Technical Officer, “FHIR Over Direct: Accelerating the Pace toward Trusted, Scalable Interoperability,” by exploring how the same approach of FHIR Over Direct can be applied to socialcare — a critical but often underrepresented component of health and well-being.