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CMS Releases Updated 2026 QRDA III Implementation Guide for Eligible Clinicians

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CMS has published the updated 2026 Quality Reporting Document Architecture (QRDA) Category III Implementation Guide (IG) for Eligible Clinicians, incorporating changes finalized in the 2026 Medicare Physician Fee Schedule (PFS) Final Rule released on October 31, 2025. The updated guide outlines technical and reporting requirements for submitting electronic clinical quality measures (eCQMs) for Calendar Year 2026 quality programs. Key updates include the addition of new MIPS Value Pathway (MVP) identifiers across several specialties, new eCQM…
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CMS Releases 2026 QCDR Measure Specifications for MIPS Reporting

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CMS has published the 2026 Qualified Clinical Data Registry (QCDR) Measure Specifications, providing clinicians and organizations with an early look at quality measures available for the upcoming MIPS performance year. Released on December 22, 2025, the specifications allow clinicians, groups, virtual groups, subgroups, and APM Entities—including Medicare Shared Savings Program ACOs—to identify QCDR measures that align with their specialty and reporting needs. The file includes a full list of CMS-approved QCDR measures and identifies which…
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CMS Releases Latest Medicare Diabetes Prevention Program (MDPP) Bulletin

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The Centers for Medicare & Medicaid Services (CMS) has released the latest edition of the Medicare Diabetes Prevention Program (MDPP) Bulletin, the agency’s quarterly newsletter for the MDPP community. Published by the CMS MDPP Team, the bulletin provides updates, resources and insights to support organizations and professionals working to prevent or delay the onset of Type 2 diabetes among Medicare beneficiaries. This edition includes: CMS encourages MDPP suppliers to review the newsletter and share it…
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CMS Updates eCQI Resource Center With MIPS Value Pathway Integration

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The Centers for Medicare & Medicaid Services (CMS) has updated the Electronic Clinical Quality Improvement (eCQI) Resource Center to better connect quality reporting resources across CMS programs. As part of the update, the 2026 Eligible Clinician eCQM table now includes direct links to MIPS Quality measures and MIPS Value Pathways (MVPs) on the Quality Payment Program website. The enhanced measure details help clinicians and practices more easily align their reporting strategies and include traditional MIPS…
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Must-See Updates in the MLN Connects Newsletter

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The latest MLN Connects® Newsletter from the Medicare Learning Network® is now available — your essential source for current Medicare fee-for-service policies, education, and provider guidance from CMS. Centers for Medicare & Medicaid Services Key Highlights You’ll Find Inside New DMEPOS Accreditation Changes — Finalized provisions to strengthen program integrity. Centers for Medicare & Medicaid ServicesPEPPER Relaunch — Updated Program for Evaluating Payment Patterns to support provider compliance. Centers for Medicare & Medicaid Services2026 Calendar…
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Aetna Simplifies Prior Authorization With Bundled Clinical Reviews

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Aetna is rolling out new initiatives aimed at reducing administrative burden for providers by bundling pharmacy prescriptions and medical procedures into a single clinical review, according to a Dec. 4 announcement. Previously, providers were required to submit separate prior authorizations for medical services and related medications. As of November, providers now submit one medical review, with associated medications covered under the Aetna pharmacy benefit automatically approved. As part of this effort, Aetna also introduced a…
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ACIP Recommends Shared Decision-Making for Hepatitis B Vaccination in Certain Infants

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On December 5, 2025, the CDC’s Advisory Committee on Immunization Practices (ACIP) voted 8–3 to recommend shared clinical decision-making for parents considering the hepatitis B vaccine, including the birth dose, for infants born to women who test negative for the virus. Under this approach, parents and healthcare providers should evaluate vaccine benefits, potential risks, and an infant’s likelihood of exposure before deciding when or whether to begin the hepatitis B vaccine series. For infants who…
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How Physicians Can Reduce Risk and Respond to Stark Law Allegations

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Maintaining Stark Law compliance is critical, as violations can result in significant financial penalties, exclusion from federal healthcare programs and exposure under the False Claims Act. In a recent blog post, the Health Law Offices of Anthony Vitale outlined practical steps physicians and healthcare organizations can take to reduce risk and respond effectively to Stark Law allegations. Resource: How physicians can reduce risk and respond to Stark law allegations

Southeast Health Medical Center Earns Five-Star Recognition in Forbes’ Inaugural Rankings

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Forbes unveiled its inaugural Top Hospitals 2026 rankings on Dec. 4, evaluating U.S. general acute care hospitals based on quality, clinical outcomes, value, and patient experience. The new ranking is designed to differ from traditional hospital scorecards by relying heavily on publicly available CMS data and placing the greatest emphasis on measurable patient outcomes. According to Forbes, the methodology stands out in three key ways: it draws primarily from CMS’ Provider Data Catalog, assigns the…
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CDC Alerts Providers to Marburg Virus Outbreak in Ethiopia

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The Centers for Disease Control and Prevention (CDC) has issued a Health Alert Network (HAN) advisory regarding a new outbreak of Marburg virus disease (MVD) in Ethiopia’s South Ethiopia and Sidama regions. Marburg virus is a rare but severe hemorrhagic fever with a high fatality rate. As of December 3, 2025, no suspected, probable, or confirmed cases linked to this outbreak have been reported in the United States or in countries outside Ethiopia. The CDC…
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CMS Updates eCQI Resource Center with MIPS Value Pathway (MVP) Integration

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The Centers for Medicare & Medicaid Services (CMS) has updated the Electronic Clinical Quality Improvement (eCQI) Resource Center to strengthen continuity and connections across CMS resources. The 2026 Eligible Clinician eCQMs table now includes direct links to MIPS Quality and MIPS Value Pathways (MVPs) on the Quality Payment Program (QPP) website. New measure details include: Visit the eCQI Resource Center

CMS Releases 2026 Medicare Participation Update and Final Home Health Payment Rule

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CMS has issued two major updates for 2026: the Medicare Participation Announcement and the final rule for the CY 2026 Home Health Prospective Payment System (HH PPS). Both outline the agency’s strategic priorities for the coming year and the financial impact on home health providers. 2026 Medicare Participation Announcement CMS released its annual participation letter, reaffirming its partnership with clinicians and emphasizing Medicare’s role as one of the nation’s most impactful bipartisan programs. The agency…
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