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Alabama Hospitals Rank Among the Shortest ED Wait Times for Mental Health Patients

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New data from CMS’s Timely and Effective Care–Hospital dataset highlights national trends in emergency department (ED) wait times for psychiatric and mental health patients, and two Alabama hospitals ranked among the best in the country. The dataset, released August 6, evaluates ED visits from January through December 2023 and measures the median length of stay for mental health patients. Nationally, the median ED visit time was 271 minutes, up slightly from 267 minutes the previous…
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Medicare Participation Reminder for CY 2026: Decisions Due by December 31

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As the new year approaches, CMS is reminding physicians, practitioners, and suppliers to review their Medicare participation status for Calendar Year (CY) 2026. All providers must finalize their decision by December 31, 2025. Why Participation Matters Choosing to participate in Medicare offers several key advantages: Who Doesn’t Need to Take Action? No action is needed if you: Providers who want to change their Medicare participation status should visit CMS’s Annual Medicare Participation Announcement page for…
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CMS Finalizes 2026 Medicare Physician Fee Schedule: Key Updates & Reimbursement Changes

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CMS has released its final rule for the 2026 Medicare Physician Fee Schedule, including major reimbursement changes, updated conversion factors, and policy shifts affecting physician practices, ACOs, and specialty care models. 1. Two Separate Conversion Factors For 2026, CMS will use two different conversion factors: 2. New Conversion Factor Amounts 3. What Drives These Increases Each conversion factor reflects: 4. New 2.5% Efficiency Adjustment CMS finalized a –2.5% efficiency adjustment to work RVUs and physician…
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Teva Recalls Over 580,000 Bottles of Blood Pressure Medication Due to Impurity Concerns

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Teva Pharmaceuticals has issued a voluntary recall of more than 580,000 bottles of prazosin hydrochloride, a commonly prescribed blood pressure medication, after routine quality testing detected a nitrosamine impurity known as N-nitroso Prazosin impurity C. According to the FDA, long-term exposure to nitrosamines above established limits may increase the risk of cancer. The recall has been designated as Class II, meaning the likelihood of serious adverse health effects is considered remote, but temporary or medically…
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10 Key Things Providers Should Know About the Stark Law

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The Stark law remains one of the most significant federal regulations governing financial relationships in healthcare. It aims to prevent fraud and abuse by prohibiting physician self-referrals for certain Medicare and Medicaid services. A recent overview from the law firm Eisner Gorin highlights several important updates and reminders for providers. What the Stark Law Covers The law bars physicians from referring Medicare or Medicaid patients for designated health services to any entity with which they…
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CMS Publishes 2026 Policy Changes for the Quality Payment Program

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The Centers for Medicare & Medicaid Services (CMS) has released the 2026 Medicare Physician Fee Schedule (PFS) Final Rule, outlining updates to the Quality Payment Program (QPP) for the 2026 performance year and beyond. The rule will be officially published on November 5, 2025, in the Federal Register. CMS emphasized program stability while continuing the shift toward MIPS Value Pathways (MVPs) and greater alignment across programs. Merit-based Incentive Payment System (MIPS) MVPs (MIPS Value Pathways)…
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Blue Cross and Blue Shield of Alabama: Upcoming Drug Policy Updates

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Effective January 1, 2026, prior authorization will be required for all denosumab products, including biosimilars, for commercial Blue Cross of Alabama members. For PEEHIP plans, beginning October 1, 2025, the same preferred products apply. All other denosumab versions will be non-covered, with proactive authorizations added for current patients. Additional PEEHIP medical drug updates (effective Jan. 1, 2026) include changes to coverage and preferred products across multiple drug classes, such as myasthenia gravis therapies, pegfilgrastim, trastuzumab,…
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New CMS Model Aims to Cut Prescription Costs and Expand Access in Medicaid

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The Centers for Medicare & Medicaid Services (CMS) has introduced a new initiative aimed at lowering prescription drug costs and improving access to critical medications for Medicaid beneficiaries. The GENErating cost Reductions fOr U.S. Medicaid (GENEROUS) Model, set to launch in 2026, will allow participating states to purchase certain drugs at internationally competitive prices to reduce spending and promote affordability. The model encourages state Medicaid programs and drug manufacturers to collaborate on transparent, uniform pricing…
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CMS Issues Update on Medicare Telehealth Payment Limitations

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As of October 1, 2025, many of the temporary telehealth flexibilities introduced during the COVID-19 Public Health Emergency have expired, following the absence of new Congressional action. This means several statutory payment restrictions under Medicare are now back in effect, including: Certain services remain exempt, including behavioral and mental health, monthly ESRD-related clinical assessments, and telehealth provided by Medicare Shared Savings Program ACOs. To comply with current law, CMS has directed Medicare Administrative Contractors (MACs)…
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CMS: All 50 States Apply for $50 Billion Rural Health Transformation Program

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The Centers for Medicare & Medicaid Services (CMS) announced that all 50 states have applied for the new $50 billion Rural Health Transformation Program, a landmark initiative to improve access, quality, and sustainability of care in rural communities across the U.S. Created under the Working Families Tax Cuts legislation (Public Law 119-21), the program empowers states to design and implement customized plans that address local health challenges and expand care access for rural populations. The…
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UAB Hospital Among Elite Group with Five or More Magnet Designations

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Less than 2% of the nation’s 6,093 hospitals have earned Magnet designation at least five times, according to the American Nurses Credentialing Center (ANCC). The Magnet program recognizes hospitals for nursing excellence, quality patient care, and innovations in professional practice. Of the nearly 650 Magnet-recognized hospitals worldwide, only 112 have achieved this distinction five or more times — and UAB Hospital in Birmingham is among them, with an impressive six Magnet designations. This recognition highlights…
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Will RVUs Survive in a Value-Based Future?

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Relative value units (RVUs) have long been the standard for measuring physician productivity and determining compensation. But as healthcare moves toward value-based care, the traditional RVU model faces growing scrutiny. RVUs, established in the late 1980s, account for work effort, practice expenses, and malpractice costs, and remain central to how CMS and health systems calculate reimbursement. Yet despite rising workloads, physician productivity increased 12% year over year in 2025, according to Kaufman Hall, while reimbursement…
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