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CMS Open Payments Review Period Now Open for 2025 Data

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Centers for Medicare & Medicaid Services has opened the review period for Program Year 2025 Open Payments data, giving covered recipients an opportunity to verify submitted information before it becomes public in June. Reporting entities submitted data between February 1 and March 31, and providers are now encouraged to review records for accuracy. While participation is voluntary, reviewing this data is critical to ensuring that any reported financial relationships are accurate and properly represented. The…
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UnitedHealthcare Expands Rural Initiatives, Reduces Prior Authorizations

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UnitedHealthcare is scaling its rural healthcare initiatives nationwide, introducing faster payment timelines and easing administrative requirements for hospitals and providers in underserved areas. A key component of the expansion includes accelerating reimbursements—cutting payment timelines by up to 50%—for approximately 1,500 hospitals, including all critical access hospitals. Early results from its Rural Payment Acceleration Pilot show Medicare Advantage payments reaching hospitals in under 15 days on average, a significant improvement from traditional timelines. The program, initially…
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Community Health Systems Expands ASC Footprint Across Key Markets

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Community Health Systems is continuing to grow its ambulatory surgery center (ASC) network in 2026 through a combination of acquisitions and new facility development, reinforcing the broader industry shift toward outpatient care delivery. The system recently opened new ASCs in Alabama—including Birmingham and Foley—and expanded into Alaska with the acquisition of a majority stake in a surgery center in Anchorage, bringing its total to 36 affiliated ASCs. An additional acquisition of Surgical Institute of Alabama…
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Flu Activity Declines Nationwide, Pediatric Risk Remains Elevated

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Flu activity across the U.S. continues to trend downward, with cases and hospitalizations declining for the ninth consecutive week, according to the Centers for Disease Control and Prevention. The 2025–2026 flu season is currently classified as moderate in severity for the general population, signaling overall improvement as the season progresses. However, risk remains significantly higher for pediatric populations. The season is still considered high-severity for children, with recent reported deaths bringing the total to 143—well…
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Court Dismisses Aetna Lawsuit Over Radiology Billing Dispute

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A federal judge in the U.S. District Court for the Middle District of Florida has dismissed a lawsuit brought by Aetna against radiology providers, marking a notable development in disputes tied to the No Surprises Act. The case centered on allegations that Radiology Partners and Mori, Bean and Brooks leveraged the law’s independent dispute resolution (IDR) process to secure higher reimbursements on out-of-network claims. According to court filings, Aetna argued that tens of thousands of…
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Integrating Psychological Care to Improve Patient Outcomes

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As healthcare continues to move toward whole-person, value-based care, integrating psychological support into treatment plans is becoming increasingly essential—particularly for patients undergoing high-stress interventions such as oncology care, chronic disease management, and in-vitro fertilization (IVF). Research shows that psychological distress is not a secondary concern but a core clinical factor that directly impacts treatment adherence, decision-making, and overall outcomes. Embedding psychologists within care teams allows providers to proactively address stress, rather than treating it as…
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CMS Proposes Expanding Prior Authorization Rules to Include Prescription Drugs

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The Centers for Medicare & Medicaid Services (CMS) has introduced a proposed rule that would extend its prior authorization interoperability framework to prescription drugs for the first time, building on its earlier efforts focused on medical services. Key Highlights for Providers: Resource: CMS proposes extension of prior authorization rule to cover drugs: 6 notes

Alabama Healthcare Update: Veteran Recognition, Workforce Leadership, and Rural Funding Pressures

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Veteran Care & RecognitionAndalusia Health has become the first hospital in Alabama to receive designation as a Purple Heart Hospital, recognizing veterans who were wounded or killed in combat. The facility is implementing visible and ongoing initiatives—such as dedicated signage and recognition programs—to better honor and support veteran patients within its care environment. Healthcare Education & WorkforceThe University of Alabama at Birmingham (UAB) continues to strengthen its national reputation, with its Master of Science in…
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New Index Reveals Widespread Mental Health Coverage Gaps Across 43 States

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A new Mental Health Parity Index—developed by organizations including the American Medical Association—highlights ongoing disparities between mental and physical healthcare access across the U.S., despite existing parity laws. Built using transparency data from the Centers for Medicare & Medicaid Services (CMS), the tool analyzes payer networks, reimbursement, and access to care. Its findings show that 43 states still face significant gaps in access to in-network mental health and substance use disorder services. Key Trends Identified:…
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CDC Data Highlights Decline in Respiratory Illnesses, but Ongoing Risks for Children

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New data from the Centers for Disease Control and Prevention (CDC) shows a broader decline in respiratory illnesses across the U.S., but serious concerns remain—particularly for pediatric populations. This flu season has been especially severe for children, with 139 pediatric deaths reported, including a recent weekly increase. Notably, the majority of these cases involved unvaccinated children, reinforcing the role of immunization in preventing severe outcomes. Overall, the U.S. has seen at least 31 million flu…
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CMS Releases Final HCPCS Level II Coding Decisions for Q1 2026

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The Centers for Medicare & Medicaid Services (CMS) has published its final determinations for the HCPCS Level II Q1 2026 coding cycle, providing important updates for providers, suppliers, and billing teams. This release includes new codes, revisions, and other coding decisions that may directly impact claims submission and reimbursement. Each decision is supported by detailed documentation outlining the coding issue, a summary of the original request, and CMS’ final determination—giving providers helpful context behind each…
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