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Study Finds Medicare Add-On Code G2211 Increasing Physician Payments

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A study published in JAMA found that the Medicare add-on billing code G2211 generated about $394 million in payments in 2024, its first year of use, after being billed 26 million times for 10.6 million patients. Although the code was originally intended to support primary care providers managing ongoing or complex patient care, specialists accounted for a large share of usage due to Medicare rules preventing specialty-restricted billing codes. The findings highlight how the code—introduced…
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Medicare Extends No-Pay Summary Notice Mailing Timeline

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Centers for Medicare & Medicaid Services has updated the mailing schedule for No-Pay Medicare Summary Notice (MSN) statements, changing the frequency from every 120 days to every 180 days beginning Jan. 1, 2026. The update applies to notices sent when no claims payments are made during a period, and CMS is also encouraging beneficiaries to opt for digital MSNs to access their notices electronically instead of waiting for mailed statements. Resource: No-Pay Medicare Summary Notice…
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CDC Study Highlights Measles Spread Linked to Air Travel

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Researchers from the Centers for Disease Control and Prevention reported that an unvaccinated traveler who flew from Europe to the United States while infectious with Measles transmitted the virus to 17 additional people, including passengers exposed during flights, at the airport, and through subsequent community spread. The investigation traced 135 exposed travelers, with infections occurring on both international and domestic flights, and several cases requiring hospitalization. The findings highlight the importance of vaccination before international…
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Congress Restores 3.1% Medicare APM Bonus for Physicians

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A provision in the Consolidated Appropriations Act, 2026 restores a 3.1% incentive bonus for physicians participating in Medicare Alternative Payment Models (APMs) for the 2026 performance year. The bonus, which had expired in 2024, was reinstated through the bipartisan funding package passed by Congress and will be paid to eligible physicians in the 2028 payment year, consistent with the payment timeline established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Resource: 3.1%…
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CMS Transitions CLIA Program to Fully Paperless System

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Centers for Medicare & Medicaid Services has completed the transition to a fully paperless system for the Clinical Laboratory Improvement Amendments (CLIA) program. CLIA certificates and fee coupons will no longer be mailed, and all certification and survey fees must now be paid online rather than by paper check. Laboratories must also ensure they have a valid email address on file to receive electronic certificates, billing notices, and other CMS communications to avoid potential certification…
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UnitedHealthcare Introducing New Referral Requirements for Some Medicare Advantage Plans in 2026

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Beginning Jan. 1, 2026, UnitedHealthcare will require most members enrolled in Medicare Advantage HMO and HMO-POS plans to obtain a primary care provider (PCP) referral before seeing certain specialists in outpatient, office, or home settings. Referrals must be submitted to UnitedHealthcare before the visit (and can be backdated up to five days), though many specialties and services—including mental health, OB/GYN, radiology, therapy services, labs, preventive care, telehealth, and emergency care—are excluded from the referral requirement….
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U.S. Measles Cases Surge Past 1,100, Raising Public Health Concerns

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The Centers for Disease Control and Prevention reports more than 1,100 measles cases nationwide so far this year, putting the U.S. on pace for a record-breaking surge. As of Feb. 26, 1,136 cases had been reported—already six times higher than a typical full-year total in recent years. Health officials warn of serious complications, noting that approximately 1 in 1,000 infected children may develop encephalitis (brain swelling), and up to 3 in 1,000 may die. A…
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Southern States Among Leaders in U.S. News’ Top Home Health Rankings

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In its inaugural Best Home Health ranking, U.S. News & World Report evaluated more than 12,000 Medicare-certified agencies nationwide using CMS quality and patient experience data. Just over 11% (1,320 agencies) earned the Best Home Health distinction for exceeding national benchmarks in timely care, patient improvement outcomes, and reduced preventable hospitalizations. Among the Southeast states highlighted: Top-rated agencies began care on time for 99% of patients (compared to 94% nationally) and demonstrated stronger improvement rates…
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Six Health Systems Named to Fortune’s Most Admired Companies List — Including Birmingham’s Encompass Health

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Six major health systems earned recognition on the 28th annual World’s Most Admired Companies list by Fortune and Korn Ferry, which evaluates companies on leadership, talent, quality, and social responsibility. Notably for Alabama, Encompass Health, based in Birmingham, ranked No. 4 in the medical facilities category. Other recognized systems include HCA Healthcare (No. 1 in its category for the 12th consecutive year), Universal Health Services, Tenet Healthcare, Ardent Health, and Community Health Systems. Resource: 6…
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Novo Nordisk to Cut U.S. List Prices for Wegovy, Ozempic, and Rybelsus in 2027

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Novo Nordisk announced it will reduce the U.S. list price of Wegovy, Ozempic, and Rybelsus to $675 per month beginning Jan. 1, 2027—representing an approximate 50% reduction for Wegovy and 35% for Ozempic across all doses. The company stated the change is designed to improve affordability for patients whose out-of-pocket costs are tied to list prices, such as those with high-deductible plans or coinsurance, and will not impact existing self-pay options like NovoCare. The adjustment…
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Study Finds Medicare Patients Use Telehealth Broadly—Not Just for Behavioral Health

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New research from the University of Utah, conducted with support from the University of Michigan and the Veterans Affairs Center for Clinical Management Research (CCMR), shows that telehealth is widely used by Medicare beneficiaries for both behavioral and non-behavioral health concerns. Between 2021 and 2023, a sample of 15,000 Medicare patients accounted for roughly 31 million annual telehealth visits for behavioral health and 29 million for other conditions, including chronic care. The findings challenge the…
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Alabama Bill Would Require Physician Review and Greater Transparency for AI-Driven Prior Authorizations

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The Alabama Senate has passed legislation that would restrict how insurers use artificial intelligence in prior authorization decisions, requiring that any denial be made by a physician or qualified provider rather than AI alone. The bill mandates that AI tools base determinations on a patient’s individual medical history and clinical documentation—not solely on group-level data—and requires annual certification to the Alabama Department of Insurance confirming systems are non-discriminatory and produce consistent outcomes. Insurers would also need…
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