Birmingham 205-631-5969

Montgomery 334-277-6201

Client Login

Request Demo

Category: General

Key CMS & Medicare Updates for Alabama Providers

Posted on

Alabama Receives $144 Million to Strengthen Rural Health Care Alabama is receiving $144 million through the federal Rural Health Transformation Program to support 138 grants focused on expanding access to care, improving mental health and substance abuse services, strengthening emergency and maternal care, modernizing health care technology and infrastructure, and growing the rural health workforce. The investment is expected to help improve health care delivery and access across rural communities in Alabama. Resource: Trump Administration Announces $144…
Read Full Article

CMS Releases FY2027 ICD-9 and ICD-10 Diagnosis Code Lists

Posted on

CMS has released the updated ICD-9 and ICD-10 valid and excluded diagnosis code lists for Fiscal Year 2027, which take effect in October 2026. Providers and billing teams should review the updated lists to ensure they are using the appropriate diagnosis codes and are aware of any codes that are no longer valid or are excluded under the updated FY2027 guidelines. Reviewing these changes ahead of the October implementation date can help practices avoid potential billing or…
Read Full Article

CMS Clarifies Medicare Enrollment Requirements for Telehealth and Teleradiology

Posted on

CMS has updated its guidance on Medicare enrollment for telehealth and teleradiology providers, clarifying how providers should report practice locations when services are delivered remotely. For telehealth, providers who work from home but maintain a physical practice location generally do not need to report their home address on their Medicare enrollment. However, providers who operate entirely through virtual care and have no other physical practice location must report their home address, using the appropriate practice location designation to help…
Read Full Article

UnitedHealth Challenges IRS Proposal That Could Increase Tax Liability

Posted on

UnitedHealth Group is disputing proposed tax adjustments from the IRS related to transactions with an unnamed foreign subsidiary between 2017 and 2020. The IRS is seeking to increase the company’s taxable income for those years and could pursue additional adjustments for later periods. UnitedHealth said it disagrees with the proposed changes and plans to challenge the IRS position through available administrative and legal processes. The company also reported that its existing reserves for uncertain tax positions are sufficient…
Read Full Article

250 Hospitals Earn Five-Star CMS Patient Experience Ratings

Posted on

CMS has released updated patient experience data showing that 250 hospitals received the highest five-star rating for overall patient experience. The ratings are based on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, which measures patients’ experiences during recent hospital stays. The latest data reflects surveys collected from Oct. 1, 2024, through Sept. 30, 2025, and was made public Aug. 13, 2026. The overall hospital rating is based on patients’ responses about their experience and uses a…
Read Full Article

Alabama Medicaid Updates EPSDT Screening Schedule

Posted on

The Alabama Medicaid Agency has updated its Early and Periodic Screening, Diagnostic and Treatment (EPSDT) periodicity schedule for services provided on or after Oct. 1, 2025. The changes align with the American Academy of Pediatrics’ Bright Futures guidelines and add well-child visits at 3–5 days of age and 30 months, along with hearing, vision, and developmental screenings. The updated schedule includes visits at 3–5 days, 1, 2, 4, 6, 9, 12, 15, 18, 24, and 30 months, followed by annual…
Read Full Article

CMS Releases Final HCPCS Level II Coding Determinations for B1 2026

Posted on

CMS has released the final HCPCS Level II coding determinations for the First Biannual 2026 (B1 2026) cycle covering non-drug and non-biological items and services. The release includes decisions on new and revised HCPCS codes, along with information on Medicare benefit categories and payment determinations. For each application, CMS provides details on the request, preliminary decisions, public feedback, and the final coding, benefit category, and payment determinations. Providers and billing professionals can review the complete B1 2026 determinations…
Read Full Article

Humana Expands Prior Authorization Tools for Diagnostic Imaging

Posted on

Starting Jan. 1, 2026, CMS requires health plans to provide decisions on standard prior authorization requests within 7 days, making complete documentation at the time of submission especially important. Humana providers submitting outpatient Medicare prior authorization requests through Availity Essentials must include the supporting clinical documentation with their request, although some exceptions may apply. Humana has also introduced an enhanced prior authorization workflow through Availity Essentials for diagnostic imaging in Georgia, North Carolina, South Carolina, and Virginia. The updated process is designed…
Read Full Article

Seven Alabama Hospitals Recognized Among the Best Regional Hospitals

Posted on

U.S. News & World Report has released its 2026–27 Best Regional Hospitals rankings, with seven Alabama hospitals earning recognition for their overall performance and specialty care. UAB Hospital ranked No. 1 in Alabama, receiving national recognition in two adult specialties and high-performing ratings in 18 procedures and conditions. UAB St. Vincent’s Birmingham ranked No. 2 statewide, with nine high-performing adult procedures and conditions. Children’s Hospital of Alabama was also recognized as the top children’s hospital in the state, earning…
Read Full Article

Lawsuits Raise Questions About AI Accountability in Healthcare

Posted on

As artificial intelligence becomes more common in healthcare, several lawsuits are testing who may be responsible when AI is involved in decisions or guidance related to patient care, insurance coverage and clinical operations. Becker’s highlighted three cases that illustrate some of the legal and compliance questions emerging around healthcare AI: Resource: 4 lawsuits testing where AI accountability lands in healthcare

ANA Recognizes New Nursing Specialties as the Profession Expands

Posted on

The American Nurses Association (ANA) has formally recognized several new nursing specialties in recent years, reflecting the growing need for specialized knowledge and skills across healthcare. ANA recognition establishes a defined scope of practice and standards for each specialty, which can help guide education, credentialing and staffing. The newest specialties recognized by ANA include: The development of these specialties reflects a broader shift toward formalizing specialized nursing expertise and creating clearer standards for training, credentialing and practice….
Read Full Article

Cannabis Hyperemesis Syndrome Diagnoses Rise as New Code Improves Tracking

Posted on

Emergency department diagnoses of cannabis hyperemesis syndrome (CHS) have increased as healthcare providers gain a more accurate way to identify and track the condition. CHS can cause recurring nausea, severe vomiting and abdominal pain and is most commonly associated with frequent cannabis use. According to a recent CDC report, emergency department diagnoses increased after a dedicated ICD-10-CM diagnosis code for cannabis hyperemesis syndrome was introduced last fall. Researchers noted that the condition may have been underrecognized in the past…
Read Full Article