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.
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The calendar year 2026 Medicare Physician Fee Schedule proposed rule would advance primary care management through new quality measures, reduce waste and unnecessary use of skin substitutes, and introduce a new payment model focused on improving care for chronic disease management.
This month’s AI report includes news and updates from Data Buddies, Omega Healthcare, Microsoft, WellLink, Predictmedix, VisiQuate, CMS, Eko Health, Colorado Access, Innovacer, SuperDial, Arrive AI, VSee, CoreCare, ScienceSoft, John Snow Labs, Suki, Ambience Healthcare, City of Hope, FinThrive, RadiantGraph, PacificAI & more.
As of July 1, 2025, the 2026 Self-Nomination period for Qualified Clinical Data Registries (QCDRs) and Qualified Registries is now open. QCDRs and Qualified Registries are Centers for Medicare & Medicaid Services -approved intermediaries that collect clinical data on behalf of clinicians for data submission.
By Vanessa Candelora – In our May 2025 HIT Perspectives article, we unpacked the decade-long journey of healthcare price transparency and why most stakeholders would agree we’re still not where we need to be. Despite multiple rounds of rulemaking, patient usage of price tools remains low, and many organizations remain out of compliance with core requirements.
The Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (Innovation Center) has released and are highlighting evaluation reports and publications. See the findings for several of their models.
The 2026 Self-Nomination Toolkit for Qualified Clinical Data Registries and Qualified Registries, including the below files, are now posted on the QPP Resource Library.
By Bernard J. Wolfson – Republican efforts to restrict taxes on hospitals, health plans, and other providers that states use to help fund their Medicaid programs could strip them of tens of billions of dollars. The move could shrink access to health care for some of the nation’s poorest and most vulnerable people, warn analysts, patient advocates, and Democratic political leaders.
HHS Secretary Kennedy and CMS Administrator Oz press conference on securing industry pledges to fix the broken Prior Authorization System. They met with insurance leaders of nearly 80% of covered Americans.