By Lara Dixit – EHR integration frequently fails for reasons other than a weak interface engine, an inaccessible API, or a lack of technical expertise on the part of the vendor. It fails because the clinical workflow was never clearly mapped before systems were connected.
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By Dr. Apurva Jain – The CMS-0057 Interoperability and Prior Authorization Final Rule released in January 2024 and implemented between January 2026 and January 2027 is a welcomed step in the modernization of prior authorizations (PA). In addition to new measures such as promoting and standardizing digital workflows….
By Don Rucker MD – Price transparency has become an increasing requirement for providers and payers over the last number of years, including for out-of-network costs under the No Surprises Act. CMS has been on a multi-year campaign to extend transparency throughout its programs.
By Mark Coetzer – Questions about technology investments, interoperability requirements, staffing needs, and reporting workflows are all valid considerations as providers and payers evaluate what it will take to support a more digital approach to quality measurement.
Fosters Innovation for the Medicare Drug Price Negotiation Program – A new proposal from the CMS would establish a permanent framework for the Medicare Drug Price Negotiation Program, creating a more transparent and sustainable process for lowering drug costs for millions of Medicare beneficiaries.
By Leigh Poland – At first glance, the April 1, 2026, ICD 10 update from CMS and NCHS looks deceptively quiet. ICD 10 CM adds no new diagnosis codes, retires none, and leaves the Official Coding Guidelines untouched. It reads like a maintenance cycle, but that surface-level stability masks a more meaningful shift.
By Michelle Tarver MD PhD – For five decades, the 1976 Amendments have served as the foundation of a regulatory framework designed to protect patients while advancing innovation. It has ultimately helped to ensure that medical devices are safe, effective, and high-quality for the people who rely on them.
This rule, finalized by the HHS, through CMS, the Department of Labor and the Department of the Treasury along with the Office of Personnel Management, directly addresses bottlenecks by helping to reduce the number of ineligible disputes entering the system at a lower cost to payers and providers.
The 2026 Quality Payment Program (QPP) exception applications are now available through December 31, 2026, at 8 p.m. ET. There are 2 types of exception applications that allow participants to indicate why they can’t report data for one or more Merit-based Incentive Payment System (MIPS) performance categories.