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Author: Lauren Brown

CMS Finalizes 1.3% Payment Cut for Home Health in 2026: 8 Key Updates

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CMS has finalized a 1.3% decrease in home health payments for 2026, part of its annual Home Health Prospective Payment System update released Nov. 28. The rule includes permanent and temporary payment adjustments tied to the Patient-Driven Groupings Model (PDGM) and several policy changes aimed at easing administrative burdens while strengthening fraud prevention. Here are the eight main updates: Resource: CMS cuts home health pay: 8 things to know 

UnitedHealthcare Announces Key 2026 Medicare Advantage Plan Changes

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UnitedHealthcare has outlined several updates to its Medicare Advantage plans for 2026, including new referral requirements and changes to supplemental benefit eligibility. 1. Most HMO and POS plans will require referrals.Beginning Jan. 1, 2026, members enrolled in UnitedHealthcare Medicare Advantage HMO and POS plans will need a referral from their primary care provider before seeing certain specialists in outpatient, office, or home settings. PCPs must submit the referral to UnitedHealthcare prior to the specialist visit….
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Flu Activity Still Low but Rising: 5 Key Virus Updates

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Flu activity across the U.S. remains relatively low but is beginning to increase — especially among children and young adults — according to the CDC’s latest FluView report published Dec. 1. In the week ending Nov. 22, flu-related hospitalizations rose sharply to 3,264, a 39% jump from the previous week. Outpatient visits for flu-like illness also edged up to 2.5%, still below the national baseline of 3.1%. Young children (ages 4 and under) continue to…
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RSV Admissions Remain Low but Are Starting to Rise: 4 Key Respiratory Virus Updates

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Hospitals are beginning to see a gradual uptick in respiratory syncytial virus (RSV) admissions, although national numbers remain limited due to delayed federal reporting. Cincinnati Children’s Hospital is among those noting earlier-than-usual activity, with Hamilton County recording 32 RSV admissions in the week ending Nov. 15 — slightly up from 28 the week prior. National CDC estimates, last updated Oct. 25, show RSV hospitalizations remain low at 0.2 per 100,000 people, but are trending upward….
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CMS Releases 2026 Medicare Parts A & B Premiums, Deductibles & Coinsurance

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CMS has announced the 2026 cost updates for Medicare Parts A and B, outlining new deductible and coinsurance amounts that will take effect next year. These changes impact inpatient hospital stays, skilled nursing facility care, and outpatient services. Medicare Part A – Inpatient Hospital Costs The Part A inpatient hospital deductible will increase to $1,736 in 2026, up from $1,676 in 2025. This deductible applies to the first 60 days of Medicare-covered inpatient care.For longer…
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CMS Moves CLIA Program to Electronic Fee Coupons & Certificates

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CMS is modernizing the Clinical Laboratory Improvement Amendments (CLIA) program by shifting from mailed paper fee coupons and certificates to fully electronic delivery. Beginning March 1, 2026, laboratories and providers that perform lab testing must opt in to receive CLIA certificates and fee notices by email. After this date, CMS will no longer send paper versions. To transition to electronic notifications, labs can choose one of three options: This new process does not apply to…
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Alabama Physicians Driving Innovation in Advanced GI Care

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Alabama continues to strengthen its leadership in advanced gastrointestinal care thanks to a major clinical milestone led by Dr. Mohamad Eloubeidi, director of endoscopy at Northeast Alabama Regional Medical Center and president of the Alabama Gastroenterology Society. Dr. Eloubeidi recently performed Alabama’s first next-generation EUS-guided biopsy, using a device capable of collecting larger, higher-quality tissue samples. This advancement improves diagnostic accuracy for complex pancreatic and GI conditions and marks a significant step forward in the…
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CMS Requests Feedback on the MIPS Final Performance Feedback Experience

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If you’ve reviewed your 2024 MIPS final performance feedback on the QPP website, CMS is inviting clinicians and practices to share their experience through a brief survey. This is an opportunity to help shape how MIPS performance information is delivered moving forward and ensure it better supports the needs of participating providers. The survey takes no more than 15 minutes to complete and is voluntary, confidential, and conducted by independent contractors. No individuals or organizations…
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Medicare Claims Processing Update Following Government Shutdown

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After the government shutdown earlier this fall, several Medicare payment provisions expired on October 1, 2025. With the passage of the Continuing Appropriations and Extensions Act, 2026, Congress has now retroactively restored many of these policies through January 30, 2026—including key Medicare telehealth flexibilities that allow patients to receive telehealth services from home and in non-rural areas. How Claims Were Affected During the lapse, MACs processed claims based on the payment schedules available at the…
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7 Alabama Hospitals Earn CMS Five-Star Rating for Quietness

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The Centers for Medicare & Medicaid Services (CMS) has released its latest Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data, rating hospitals nationwide on patient experience — including how quiet hospital rooms are at night. Between October 2023 and September 2024, CMS surveyed patients across the country, with only 225 hospitals earning a five-star quietness rating this year — down from 313 in April. In Alabama, seven hospitals received top marks for providing…
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Cardiology faces rising demand and mounting operational pressure heading into the next decade

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Cardiology is experiencing rapid change as patient volumes grow, reimbursement tightens, and demographic shifts reshape delivery models. These five key stats highlight why many cardiology leaders expect significant pressure — and opportunity — in the years ahead: These trends point to a cardiology landscape that is growing in demand but also facing tighter margins, workforce constraints, and significant strategic shifts. Resource: 5 stats shaping cardiology’s future