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U.S. Measles Cases Continue to Rise in 2026

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The number of reported measles cases in the U.S. has already surpassed the total recorded during all of 2025, making 2026 the highest year for measles cases in more than three decades. Ongoing outbreaks in several states continue to drive case counts, highlighting the importance of staying informed on current public health guidance, vaccination recommendations, and outbreak updates.  Resource: Number of measles cases in U.S. this year has already surpassed tally for all of 2025

6 New GLP-1 Findings to Know

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As research on GLP-1 medications continues to evolve, new studies are providing insights into their potential benefits, risks, and long-term impact on patient care. Below are six recent findings healthcare providers should be aware of, with links to the full research for additional details. Resource: 6 GLP-1 findings to know

HCPCS Level II Q2 2026 Final Coding Determinations Released

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CMS has released the final HCPCS Level II coding determinations for the Q2 2026 coding cycle. The update includes new HCPCS codes, revisions to existing codes, and CMS’ final decisions on submitted coding requests. Practices should review these changes to determine whether any updates may affect coding, billing, or reimbursement. The full determination document and the October 2026 HCPCS Quarterly Update file will be available on the CMS website. Resource: HCPCS Level II Coding Decisions

Senate Inquiry Focuses on AI Use in Medicare Advantage Prior Authorization

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Two U.S. senators are requesting information from UnitedHealthcare, Humana, and CVS Health regarding their use of artificial intelligence and other automated technologies in Medicare Advantage prior authorization and post-acute care coverage decisions. The inquiry follows recent federal oversight reports that examined denial rates and prior authorization practices among Medicare Advantage plans. Lawmakers are seeking details on how these insurers use AI, algorithms, or predictive technologies to support coverage determinations, as well as the safeguards in place to…
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CMS Updates: Additional Medicare Billing and Coverage Reminders

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CMS recently released several updates that may affect provider billing, compliance, and patient care. Highlights include: Resources: Optometry Services at Nursing Facilities: Bill Correctly Screening for Hepatitis C Virus in Adults National Coverage Determination: Using HCPCS Code G0567 HCPCS Codes Used for Home Health Consolidated Billing Enforcement: October 2026 Quarterly Update Hospice Claims: Reporting a Face-to-Face Encounter for Recertification Using Telecommunications Technology Domestically Acquired Cyclosporiasis Cases in Multiple U.S. States VA Payments: Enroll in Direct…
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CMS Releases New QPP Participation Data and 2027 QRDA III Reporting Resources

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CMS has announced two important updates for practices participating in the Quality Payment Program (QPP) and Alternative Payment Models (APMs). The Quality Payment Program Participation Status Tool has been updated with the first 2026 snapshot of APM participation data, based on Medicare Part B claims from January 1 through March 31, 2026. Eligible clinicians should log into the QPP Portal to verify their information and confirm their Qualifying APM Participant (QP) or MIPS APM participation status. Providers who qualify as QPs may…
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Hospital Consolidation Continues Across the Southeast

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Hospital acquisitions and partnerships continue across the Southeast as health systems respond to financial pressures, workforce shortages, and the need to preserve access to care. Here are seven notable developments affecting Alabama, Mississippi, and Tennessee: These ongoing transactions reflect the continued trend of regional health system expansion and may influence referral networks, service availability, and patient access throughout the Southeast. Resource: 27 academic health systems acquiring hospitals

CMS Proposes New Restrictions for Remote Patient Monitoring Services

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CMS has proposed several changes to Medicare payment rules for remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) as part of the 2027 Physician Fee Schedule. Here are six key takeaways: Practices that currently use outsourced RPM or RTM services should review the proposed rule and monitor future CMS updates to understand how these changes could affect their workflows and Medicare reimbursement. Resource: CMS proposes ban on third-party remote patient monitoring: 6 notes

CMS Releases Latest Medicare Diabetes Prevention Program Newsletter

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CMS has published the latest Medicare Diabetes Prevention Program (MDPP) Bulletin, featuring program announcements, policy updates, important reminders, and resources for organizations participating in or supporting the MDPP. The newsletter provides timely information to help providers stay informed about program requirements and best practices for helping Medicare beneficiaries prevent or delay the onset of Type 2 diabetes. Resource: NewsletterMedicare Diabetes Prevention Program (MDPP)

Cervical Cancer Screening with HPV Testing: Billing Reminder for Medicare Providers

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Medicare reminds providers that cervical cancer screening with high-risk HPV testing is covered as a preventive service for asymptomatic female patients ages 30–65 once every five years. To ensure proper reimbursement, laboratories and providers should bill HCPCS code G0476 when performing a covered high-risk HPV test in conjunction with a Pap test. Practices should review their current billing and coding processes to confirm the correct code is being used for eligible Medicare patients. CMS has also provided…
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CMS Launches Medicare GLP-1 Bridge to Expand Access to Weight Loss Medications

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CMS has introduced the Medicare GLP-1 Bridge, a new initiative that allows eligible Medicare Part D beneficiaries to access certain GLP-1 medications for $50 per month. The program is designed to improve affordability for qualifying individuals while evaluating how expanded access to these medications impacts health outcomes and the Medicare program. The initiative will run through December 31, 2027 and is intended for Medicare beneficiaries who meet specific eligibility requirements. Not everyone with Medicare will qualify, including individuals who…
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Jackson Hospital Faces Uncertain Future Amid Reimbursement Negotiations

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Jackson Hospital in Montgomery continues to face an uncertain future as negotiations with Blue Cross Blue Shield of Alabama over reimbursement rates remain ongoing. Hospital leadership has indicated that without a sustainable financial agreement, the organization may be forced to cease operations. The hospital’s board is expected to review the latest proposals before making a final decision. Hospital leaders have emphasized that reaching a reimbursement agreement would provide the opportunity to stabilize operations, restore services,…
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