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Author: Lauren Brown

CDC Forecasts a Moderate Flu Season Ahead

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The CDC’s latest seasonal respiratory virus outlook suggests the 2025–26 virus season will bring similar levels of hospitalizations as last year, though the impact of flu is expected to be more moderate compared to 2024–25. What to Know While this year’s flu activity is expected to be moderate, the CDC continues to emphasize annual flu vaccination as the best protection against serious illness. Practices should ensure vaccine supply is stocked and encourage patients to get…
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Now Available: 2026 MIPS Payment Adjustment Information

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CMS has released Merit-based Incentive Payment System (MIPS) payment adjustment details for the 2024 performance period and 2026 payment year. Your 2024 MIPS final score determines whether you’ll receive a positive, negative, or neutral adjustment to Medicare payments for covered professional services in 2026. Accessing Your MIPS Feedback Participants can now log in to the Quality Payment Program (QPP) website to view their 2024 MIPS final score and related payment adjustment. Practice and ACO representatives…
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Billing Update: What’s New with Claims Holds and Vaccine Administration Edits

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Recent CMS Updates: Claims Hold and Vaccine Administration Edit CMS recently released several important billing and claims updates that may impact provider payments and telehealth services beginning October 2025. Temporary Claims Hold CMS has instructed Medicare Administrative Contractors (MACs) to temporarily hold certain Medicare claims dated October 1, 2025, and later.This includes: Providers can still submit claims, but payments will be paused until further notice while CMS awaits possible Congressional action related to expired Medicare…
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Jackson Hospital at Risk of Closing by End of October Without Financial Support

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Montgomery, Alabama–based Jackson Hospital may be forced to close by the end of October without additional financial support, according to a report from WSFA. The hospital, which recently received court approval for its Chapter 11 bankruptcy plan, is continuing operations while it works to restructure debt. However, officials told Montgomery city council members that current funds may only sustain operations for another 30 days. Hospital leadership has requested that the city back a $20 million…
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The CMS activities that will, won’t continue during the shutdown

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Following the federal government shutdown on October 1, the Centers for Medicare & Medicaid Services (CMS) has released details outlining which activities will continue and which will be paused during the lapse in funding. About 53% of CMS staff—approximately 3,300 employees—will remain active to support essential operations. What Will Continue: What Will Be Paused or Limited: Healthcare providers should be aware of potential delays in communication, policy updates, and certain CMS activities until government funding…
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Pfizer to Reduce U.S. Drug Prices Under New Federal Agreement

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Pfizer has become the first pharmaceutical company to lower the cost of its prescription medications in the U.S. through a new agreement with the federal government. The move aims to make a wide range of medications more affordable for patients and healthcare programs. Key Updates: This marks a major step toward increasing medication affordability and reshaping how prescription drug prices are negotiated in the U.S. Resource: Pfizer to lower US drug prices; White House unveils…
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Measles Cases Rise Across the U.S. in 2025 — Including Alabama

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As of September 30, 2025, the CDC has confirmed 1,544 measles cases across the United States — a significant increase compared to 285 total cases reported in 2024. Alabama is among 42 states and jurisdictions reporting confirmed cases this year. The CDC also notes 42 measles outbreaks so far in 2025, with 86% of all confirmed cases linked to outbreak clusters. This marks a sharp rise from 16 outbreaks reported during the previous year. Healthcare…
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CDC Updates Immunization Schedules: COVID-19 and Chickenpox Guidance

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The Centers for Disease Control and Prevention (CDC) has released updated adult and child immunization schedules, introducing important changes to both COVID-19 and varicella (chickenpox) vaccine recommendations. For COVID-19, the CDC now emphasizes shared clinical decision-making between providers and patients. Instead of a universal recommendation for everyone aged six months and older, clinicians are encouraged to base vaccination decisions on each patient’s individual health status and risk factors. This approach allows providers to guide patients…
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Three New CDC Reports on the 2024–2025 Flu Season

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CDC has released three new reports on the impact and severity of the 2024–2025 flu season in the United States, which was the most severe since 2017–2018. The reports highlight the effects of flu on children, the seriousness of pediatric complications, and the viruses that circulated most widely last season. Key Findings: Flu Vaccine Guidance:CDC continues to recommend that everyone 6 months and older receive a flu vaccine, ideally by the end of October. Vaccination…
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Alabama Hospitals Earn CMS 5-Star Cleanliness Ratings

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CMS has released its latest Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results, highlighting hospitals nationwide that received a 5-star rating for cleanliness. The survey reflects patient experiences between Oct. 1, 2023 – Sept. 30, 2024, with data updated on Aug. 6, 2025. We’re proud to share that four Alabama hospitals earned this top recognition: MediSYS congratulates these Alabama hospitals on their commitment to patient care and the exceptional work that led…
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Cigna to Implement E/M Coding Accuracy Policy Oct. 1

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Beginning October 1, Cigna will enforce a new Evaluation and Management (E/M) Coding Accuracy policy. The policy targets CPT codes 99204–99205, 99214–99215, and 99244–99245, reviewing claims for documentation accuracy. If supporting documentation does not meet AMA guidelines, services may be downgraded by one level. The move has faced opposition from Sen. Richard Blumenthal and the California and Texas medical associations, who have called on Cigna to reverse the policy. According to a Cigna spokesperson, the…
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Shutdown Impact on Medicare: Telehealth, Claims Processing, and Contractor Updates

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When certain legislative payment provisions (“extenders”) are set to expire, CMS directs Medicare Administrative Contractors (MACs) to place a temporary hold—typically up to 10 business days—on claims. This standard practice helps ensure payments remain accurate with statutory requirements and avoids the need to reprocess large volumes of claims if Congress acts after expiration. Providers may continue submitting claims during this period; payments will be released once the hold is lifted. Without Congressional action, beginning October…
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