Other Regulatory News
Centers for Medicare and Medicaid Services (CMS)
CMS Launches $100M ACCESS Model for Chronic Care Technology with FDA Waiver Pathway
The Centers for Medicare and Medicaid Services announced the ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) model on December 1, 2025, allocating approximately $100 million over 10 years to test outcomes-based payments for technology-enabled chronic care management in traditional Medicare. The voluntary model allows providers to receive recurring payments for managing qualifying chronic conditions, with full payment contingent on achieving measurable health outcomes. The FDA has simultaneously launched the TEMPO pilot program, which can waive typical premarket authorization requirements for digital health devices participating in ACCESS to collect real-world data. Over 250 organizations have already expressed interest in the program, reflecting significant enthusiasm from both healthcare providers and technology companies.
Source(s):
CMS’ ACCESS program brings cautious optimism from tech companies (Modern Healthcare)
CMS unveils new model aimed at functional, lifestyle medicine (Fierce Healthcare)
CMS targets chronic care, nutrition in ‘MAHA’ Medicare payment model (Modern Healthcare)
CMS Innovation Center’s ACCESS Model: What Medicare Organizations Need to Know (Healthmanagement)
FDA pilots allowing digital health devices access to CMS payment program (Medtechdive)
Tags: #DEVICE, #PROVIDER, #PATIENT
CMS Partners With CLEAR for Medicare.gov Digital Identity, Plans Third-Party Vetting for Health App Library
CMS announced a contract with CLEAR to integrate the CLEAR1 identity platform into Medicare.gov by early 2026 as part of the Health Tech Ecosystem Initiative, aimed at reducing friction and fraud during patient check-in. Separately, CMS plans to establish a Medicare.gov “app library” where third-party organizations will vet health applications to ensure they meet data privacy and other standards before promotion on the site. The CLEAR partnership represents CMS’s broader push to modernize digital identity verification across Medicare services.
Source(s):
CMS Plans To Have Third Parties Vet Health Apps Promoted On Medicare.gov (Inside Health Policy)
CMS Partners With CLEAR To Bring Digital Identity To Medicare.gov, Provider Directory (Inside Health Policy)
CLEAR inks contract with CMS to Kill the Clipboard (Fierce Healthcare)
Tags: #PATIENT, #PROVIDER, #PAYER
CMS Delays Decision on Which 1115 Waiver States Must Implement Medicaid Work Requirements by 2027
CMS has released new guidance stating that Medicaid expansion adults and those in similar programs created via Section 1115 waivers must meet work reporting requirements by January 1, 2027. However, the agency has not yet determined which specific states with expansion-like 1115 waivers will be subject to these new work requirements. The guidance leaves uncertainty for states operating Medicaid expansion programs through 1115 demonstration waivers rather than traditional expansion pathways.
Source(s):
CMS Still Reviewing Which 1115 Demos Will Be Subject To Work Reqs (Inside Health Policy)
Tags: #PATIENT, #PAYER
CMS Races to Launch Enhanced National Provider Directory with Private Sector Data by Q1 2026
CMS is working to integrate private sector data into its beta National Provider Directory by the first quarter of 2026, as part of broader interoperability initiatives. Simultaneously, private sector stakeholders are rushing to meet their own Q1 2026 targets under the Trump administration’s CMS Interoperability Framework. The agency’s efforts focus on improving provider data accuracy and accessibility through public-private collaboration.
Source(s):
CMS Works On Provider Directory, Industry Chases Agency’s 2026 Interoperability Targets (Feedly)
Tags: #PROVIDER, #PAYER, #PATIENT
CMS Issues Guidance on Medicaid Work Requirements as States Prepare for January 2027 Implementation Deadline
On December 8, 2025, CMS released anticipated guidance on Medicaid community engagement requirements established in the 2025 budget reconciliation legislation (P.L. 119-21/OBBBA). The requirements will affect over 18 million Medicaid expansion enrollees aged 19-64 starting January 1, 2027, mandating they demonstrate 80 hours monthly of work, volunteering, or education to maintain coverage. States must require applicants to show 1-3 consecutive months of community engagement prior to application, with exemptions for pregnant individuals, Medicare enrollees, and those deemed ‘medically frail,’ though states are struggling to define medical frailty criteria without sufficient federal guidance.
Source(s):
Preparing for Medicaid Community Engagement Requirements—Key Steps and Opportunities for States and Plans (Healthmanagement)
Trump SNAP and Medicaid Crisis Will Hit Hardest States That Cut Their Own Taxes (Truthout)
Medicaid work rules exempt the ‘medically frail.’ Deciding who qualifies is tricky (Ocregister)
Tracking Implementation of the 2025 Reconciliation Law: Medicaid Work Requirements Implementation Questions (KFF)
Tags: #PAYER, #PATIENT, #PROVIDER
A case for alternative payment models in pediatric care
CMS’s Integrated Care for Kids (InCK) model, launched in 2020, reimburses health systems like Duke Health for addressing social determinants of health through community partnerships, such as providing nutritious food for diabetic children or replacing carpeting in housing complexes to prevent asthma. The voluntary alternative payment model aims to compensate hospitals for preventive interventions that reduce pediatric hospitalizations, addressing the financial tension where successful prevention means fewer billable encounters for already financially-strained pediatric units.
Source(s):
A case for alternative payment models in pediatric care (Becker’s Hospital Review)
Tags: #HOSPITAL, #PATIENT, #PROVIDER
CMS Shifting Towards Data-Driven PFS, Formulating Digital Health Guidance
CMS is working to make telehealth codes in the physician fee schedule more data-driven based on recent research findings. The agency is also developing guidance specifically for digital health entrepreneurs seeking to partner with CMS.
Source(s):
CMS Shifting Towards Data-Driven PFS, Formulating Digital Health Guidance (Inside Health Policy)
Tags: #PROVIDER, #DEVICE
CMS Taking Steps On ACA’s Unimplemented Health Care Compacts
CMS is beginning implementation of ACA Section 1333, which would allow states to form Health Care Choice Compacts enabling cross-state insurance sales. CMS exchange head Peter Nelson supports the initiative, though state regulators and industry stakeholders consider it unworkable.
Source(s):
CMS Taking Steps On ACA’s Unimplemented Health Care Compacts (Inside Health Policy)
Tags: #PAYER, #PATIENT
What happened when Dr. Oz took charge of a wonky health agency
Dr. Oz conducted a staff cooking competition in the CMS headquarters parking lot in August, having employees watch while he and celebrity chef Geoffrey Zakarian tasted quinoa entries. The event was videographed, suggesting it was part of a media or promotional effort during his time leading the agency.
Source(s):
What happened when Dr. Oz took charge of a wonky health agency (Washington Post)
Tags: #ALL
How St. Peter’s prepped for the ‘nuance’ of the new Medicare prior authorization pilot
St. Peter’s Healthcare System is preparing for CMS’s new Medicare prior authorization pilot launching January 1, 2025, which targets 17 services vulnerable to fraud including epidural steroid injections and cervical fusion. The pilot uses AI companies paid based on savings from denying unnecessary services and runs through 2031 in six states including New Jersey.
Source(s):
How St. Peter’s prepped for the ‘nuance’ of the new Medicare prior authorization pilot (Becker’s Hospital Review)
Tags: #HOSPITAL, #PROVIDER
Food and Drug Administration (FDA)
FDA Plans Black Box Warning for COVID Vaccines as Agency Reviews Childhood Immunization Policies
The FDA intends to add its most serious ‘black box’ warning to COVID-19 vaccines, indicating potentially life-threatening risks that must be weighed against benefits, according to sources familiar with the agency’s plans. This comes as recent CDC data shows COVID vaccines for the 2024-2025 season remain effective, reducing emergency department visits by 76% in children ages 9 months to 4 years and 56% in those ages 5-17. The warning decision follows broader vaccine policy changes under HHS Secretary Robert F. Kennedy Jr., including Trump’s directive for CDC to reexamine the entire childhood vaccine schedule and a controversial CDC advisory panel vote to stop recommending universal hepatitis B vaccination for newborns.
Source(s):
FDA to add ‘black box’ warning to COVID vaccines, report says (Healthexec)
CDC Says Kids’ COVID Shots Reduced Emergency Department Visits (MedPage Today)
CDC: Pediatric COVID vaccines reduce ER trips by 76% (Healthexec)
How the CDC Caught the Political Virus (Realclearhealth)
FDA intends to put its most serious warning on Covid vaccines, sources say (Cnn)
Vaccines do not cause autism: WHO (Thehindu)
RFK Jr.-Founded Anti-Vaxx Group Asks FDA To Pull COVID-19 Shots (Inside Health Policy)
FDA Opens Safety Review of Injectable RSV Drugs Approved for Babies and Toddlers (MedPage Today)
STAT+: FDA scrutiny of infant RSV shots escalates amid turmoil (STAT)
More parents refusing this shot that prevents serious bleeding at birth (Usatoday)
We Must Absolutely Ignore Them’: Experts Defy CDC Panel’s Hep B Vaccine Vote (MedPage Today)
Kerfuffle continues over pending halt of hep B vaccine for babies (Healthexec)
Trump Orders Overhaul of U.S. Vaccine Schedules (Realclearhealth)
While scientists race to study spread of measles in U.S., Kennedy unravels hard-won gains (Seattletimes)
ACIP Members Say Mandates, Possible Data Gaps Motivated Hep B Vote (Feedly)
Trump Directs CDC To Reexamine Entire Childhood Vaccine Schedule (Inside Health Policy)
Tags: #PATIENT, #PROVIDER, #DRUG
GAO Report Finds Understaffed FDA Struggles with Medical Device Recall Oversight, Rarely Forces Manufacturer Action
A new Government Accountability Office report reveals the FDA is severely understaffed and rarely uses its authority to force medical device recalls, sometimes putting recall work on the ‘back burner’ with lengthy response times. The congressional watchdog investigation was requested in 2023 by Sens. Dick Durbin and Richard Blumenthal following the Philips Respironics CPAP recall crisis in 2021, where toxic foam threatened millions of patients including elderly, veterans and infants. The GAO found the FDA had received hundreds of complaints over years about the breathing machines but never ordered a recall, while Philips had fielded thousands more complaints before voluntarily initiating the recall without notifying the FDA.
Source(s):
GAO probe finds understaffed FDA putting some medical device recall work on the ‘back burner’ (Fiercebiotech)
The FDA Rarely Forces Manufacturers to Recall Dangerous Medical Devices, Watchdog Report Finds (Propublica)
Tags: #DEVICE, #PATIENT, #PROVIDER
Tracy Beth Høeg Becomes Acting Director of FDA’s Drug Center Amid Staff Concerns Over Bias
Tracy Beth Høeg became acting director of the FDA’s Center for Drug Evaluation and Research on Monday, December 9, 2025, after serving nine months as scientific adviser to FDA Commissioner Marty Makary. FDA staff have raised concerns about Høeg’s ability to oversee drug regulation without bias, citing her track record of criticism regarding COVID vaccinations and precautions. The appointment comes amid broader concerns about regulatory capture at the FDA, as several senior career officials were removed by HHS Secretary Robert F. Kennedy Jr. last summer and subsequently joined pharmaceutical companies including Eli Lilly, Pfizer, Merck, and Roche.
Source(s):
STAT+: FDA staff fear Tracy Beth Høeg will bring bias and instability to embattled drug center (STAT)
Opinion: It’s past time to update the rules intended to slow the FDA’s revolving door (STAT)
Opinion: STAT+: FDA drug center’s new acting director fits a pattern of risky, internal contradictions among agency leadership (STAT)
Tags: #DRUG, #PROVIDER, #PAYER
FDA clears next-generation cardiac mapping software
The FDA cleared an updated version of Vektor Medical’s AI-powered cardiac mapping software, adding atrial flutter mapping capabilities to the platform that originally received clearance in 2021. The San Diego company’s next-generation software includes several additional new features beyond the atrial flutter mapping functionality.
Source(s):
FDA clears next-generation cardiac mapping software (Cardiovascularbusiness)
Tags: #DEVICE, #PROVIDER
FDA commissioner on public’s growing mistrust in the government’s health advice
FDA Commissioner Marty Makary discussed public mistrust in government health advice during an NPR interview, addressing controversies surrounding COVID and Hepatitis B vaccines. The interview focused on the agency’s efforts to rebuild public confidence in federal medical recommendations amid widespread skepticism.
Source(s):
FDA commissioner on public’s growing mistrust in the government’s health advice (Npr)
Tags: #ALL
Health and Human Services
RFK Jr. as HHS Secretary Dismantles CDC Vaccine Committee, Promotes Health Misinformation While State MAHA Laws Target Public Health
HHS Secretary Robert F. Kennedy Jr. has dismissed the entire CDC vaccine advisory committee, replacing members with vaccine skeptics and conspiracy theorists, while amplifying harmful disinformation linking Tylenol to autism. The CDC has debated and ultimately scrapped its hepatitis B vaccination recommendation for newborns under Kennedy’s influence. Meanwhile, over 420 state-level MAHA (Make America Healthy Again) bills have been introduced across the US to roll back public health advances, representing a broader legislative assault on established health policies beyond Kennedy’s high-profile controversies.
Source(s):
Public Health Needs a New Motto: No Apologies, No Surrender (Thenation)
RFK Jr. Is a Public Health Disaster (Thenation)
Tags: #ALL
Heard on the Hill
Senate Rejects Competing Health Care Plans, Setting Up ACA Subsidy Cliff for January
The Senate on December 12 rejected both a Democratic bill to extend enhanced ACA tax credits for three years and a Republican alternative creating health savings accounts, with both proposals failing to reach the required 60 votes. Enhanced premium tax credits are set to expire December 31, 2025, which could cause premiums to more than double on average according to KFF. Four Republican senators broke ranks to vote for the Democratic extension, while House Republicans are preparing their own partisan package that excludes the subsidies. With only six legislative days remaining and Congress facing a potential January shutdown fight, millions of Americans face steep premium increases in 2026.
Source(s):
After failed Senate votes, is there any hope for a health care deal before premiums skyrocket? (Wmur)
ObamaCare impasse sets stage for January health care battle (The Hill)
GOP defectors raise the heat on Republicans over health subsidies vote (The Hill)
Worst. Senate. Ever. (Thebulwark)
Senate Rejects Extension of Obamacare Subsidies (MedPage Today)
Republicans flounder on health care while Trump avoids specifics (Semafor)
Does Trump have a plan to reform healthcare in America? (Bbc)
CMS data shows 5.8M Americans enrolled in ACA coverage in November—more than last year (Healthexec)
CMS: Nearly 5.8M have signed up on the ACA exchanges through November (Fierce Healthcare)
Congress’ health care headache (Politico) (Memeorandum)
Consumers make health decisions as Congress mulls tax credit expiration (Yahoo)
Uncertainty over ACA subsidies persists as enrollment deadline looms (Cnbc)
12/10/25 ☀️ AM: … Congress is grappling with the looming Obamacare cliff … (Punchbowl News) (Memeorandum)
AHIP urges Congress to extend ACA tax credits ahead of Senate vote (Healthcare Finance News)
Two health care reforms Congress can deliver now (The Hill)
Trump leaves GOP guessing on health policy (Politico)
Capitol agenda: What Trump told POLITICO about health care (Politico)
What Trump told POLITICO about health care (Politico)
Trump’s Idea for Health Accounts Has Been Tried. Millions of Patients Have Ended Up in Debt. (Kffhealthnews)
Cassidy, Crapo Roll Out HSA-Based Alternative For ACA Tax Credits Ahead Of Senate Vote (Feedly)
Affordable Care Act enrollment is slightly ahead of last year so far, despite expiring subsidies (Bostonherald)
ACA and Medicare for All Polls Reveal Voters Back Publicly Funded Health Care (Truthout)
Republicans Pushing High Deductible Insurance Plans As Deadline To Extend Tax Credits Nears (Blackenterprise)
GOP Rep. Fitzpatrick: Doing nothing on health care ‘not an option’ (The Hill)
Tags: #ALL
Medicare Telehealth Flexibilities Extended Through January 2026 as Continuing Resolution Prevents Coverage Lapse
The Continuing Appropriations Act has extended Medicare telehealth flexibilities through January 30, 2026, preventing the loss of coverage that occurred during the recent government shutdown. The extension allows distant-site practitioners to continue delivering telehealth services from their homes without reporting home addresses on Medicare enrollment applications. CMS has also clarified that federal law preempts state regulation of Medicare Advantage broker compensation, issuing a December 4 memo as UnitedHealthcare sues Idaho’s insurance director over commission requirements.
Source(s):
Medicare Coverage Is Changing Next Month (Newsweek)
Medicare Advantage 2026 Spotlight: A First Look at Plan Premiums and Benefits (KFF)
Medicare Advantage 2026 Spotlight: A First Look at Plan Offerings (KFF)
Medicare Advantage insurers unsettled as CMS scraps equity plan (Modern Healthcare)
Broker Fees and Direct Sales by Health Insurance Market (KFF)
CMS: States cannot regulate Medicare Advantage broker compensation (Beckerspayer)
CMS weighs in on Medicare Advantage marketing commission disputes (Modern Healthcare)
Tags: #PATIENT, #PROVIDER, #PAYER
Ron Johnson endorses discredited doctor’s book on chemical he claims treats autism and cancer
Sen. Ron Johnson endorsed a book by Dr. Pierre Kory promoting chlorine dioxide as a treatment for autism, cancer, and other conditions, despite FDA warnings that drinking chlorine dioxide mixtures can cause injury and death. Kory lost his medical certification for advocating unproven COVID-19 treatments, and the EPA warns that concentrations above 0.8 mg/L in drinking water can harm infants and children.
Source(s):
Ron Johnson endorses discredited doctor’s book on chemical he claims treats autism and cancer (Salon)
Tags: #PATIENT, #PROVIDER
10 Million Americans Will Lose Health Insurance by 2034 — Here’s What It’ll Cost Them
The Congressional Budget Office estimates that 10 million Americans will lose health insurance by 2034 due to the One Big Beautiful Bill Act’s $1 trillion reduction in federal spending for Health Insurance Marketplaces and Medicaid. Without premium tax credits, health insurance premiums could increase by 4.3% in 2026 and 7.9% annually through 2034, with average subsidized Marketplace premiums rising from $460 to $1,134 without enhanced tax credits. The policy change affects over 24 million Marketplace enrollees, 92% of whom currently receive advance premium tax credits.
Source(s):
10 Million Americans Will Lose Health Insurance by 2034 — Here’s What It’ll Cost Them (Yahoo)
Tags: #PATIENT, #PAYER
Notable Notes
Trump Signs Executive Order Blocking State AI Regulations, Creates Federal Task Force to Challenge Existing Laws
President Trump signed an executive order on December 11, 2025, directing the Attorney General to create a task force to challenge state AI laws and threatening to restrict federal funding from broadband deployment and grant programs to states with AI regulations. The order aims to prevent states from creating their own AI rules, with Trump arguing that requiring companies to get “50 different approvals from 50 different states” would stifle competition with China. The Commerce Department will compile a list of problematic state regulations, while David Sacks will lead the administration’s selective pushback against “the most onerous examples of state regulation.” This federal preemption effort targets the patchwork of AI laws from 38 states that enacted about 100 AI measures this year.
Source(s):
Trump signs executive order to block state AI regulations (Wmur)
AHA supports federal AI safety guidance (Becker’s Hospital Review)
Trump’s avowed AI order to face legal hurdles (The Hill)
Trump vows to block state AI regulations, calling them a threat to innovation (Fastcompany)
Tags: #ALL
Major Health Insurers Skip J.P. Morgan Conference as Industry Faces Policy Uncertainty Over ACA Subsidies and Medicaid Changes
CVS, Cigna, Humana, and other major health insurers will not present at the January 2026 J.P. Morgan Healthcare Conference for the second consecutive year, amid uncertainty over enhanced ACA premium tax credits set to expire at year-end and upcoming Medicaid changes from the One Big Beautiful Bill Act beginning in 2027. The policy uncertainty is particularly impacting California, which has the nation’s largest Medicaid program, with Blue Shield of California preparing for new Medicaid eligibility hurdles including removal of expedited renewal processes and additional semi-annual renewal requirements. Meanwhile, CMS is launching the six-state WISeR prior authorization model on January 1, requiring pre-authorization for 17 procedures in traditional Medicare.
Source(s):
CVS, Cigna, Humana, other insurers not presenting at JPM 2026 (Modern Healthcare)
How Blue Shield of California is prepping for Medicaid, ACA policy changes (Beckerspayer)
How 13 health plan leaders would redesign the payer-provider relationship (Beckerspayer)
Insurers not fully complying with price transparency rules: Study (Beckerspayer)
STAT+: Major health insurers to skip J.P. Morgan conference, again (STAT)
CVS to launch ‘engagement’ platform in gamble on consumer, industry interest (Healthcare Dive)
Humata Health prepares providers for Medicare’s WISeR model launch (HFMA)
Tags: #PAYER
Aligning for a Sustainable Healthcare Future
HFMA’s 2025 Thought Leadership Retreat identified healthcare system fragmentation as a critical challenge, with reimbursement cited as the top obstacle to stakeholder alignment. The upcoming One Big Beautiful Bill Act (OBBBA) is projected to increase uninsured Americans by 10 million over a decade, while demographic shifts will strain Medicare resources over the next 10-15 years.
Source(s):
Aligning for a Sustainable Healthcare Future (HFMA)
Tags: #ALL
DOGE isn’t dead—it’s been absorbed into the bloodstream of the government, federal employees say
DOGE has been dissolved as a centralized entity but its operatives have been integrated into individual government agencies, with former DOGE personnel now holding key positions at HHS and Treasury. The IRS has administered coding tests to employees as directed by DOGE operative Sam Corcos, while Treasury has terminated approximately 1,446 employees since Trump’s second term began. The IRS employee reports his office now has one-third of the workers it had a year ago, creating operational challenges during what is typically a quiet period.
Source(s):
DOGE isn’t dead—it’s been absorbed into the bloodstream of the government, federal employees say (Fortune)
Tags: #ALL
Health Care Consolidation and Rising Costs Happen, but Obamacare Is Not the Key Culprit
Sen. James Lankford claimed the ACA drove healthcare consolidation by moving physicians under hospitals, but experts dispute this connection. From 1998-2017, 1,573 hospital mergers occurred with the trend predating the ACA, while physician practice ownership by hospitals/private equity rose from 40% in 2012 to 58% currently, driven primarily by inadequate payment rates rather than ACA provisions.
Source(s):
Health Care Consolidation and Rising Costs Happen, but Obamacare Is Not the Key Culprit (Kffhealthnews)
Tags: #PROVIDER, #HOSPITAL, #PAYER
Health Policy in 2026
The article predicts that if enhanced ACA tax credits expire, marketplace premium spikes will become a major midterm election issue, with Democrats highlighting affordability concerns while Republicans avoid the topic. States will prepare for Medicaid work requirements starting in 2027, with red states seeking stricter implementation and blue states looking for workarounds. Health costs are expected to rise more sharply, with employer family premiums potentially approaching $30,000 and renewed focus on GLP-1 weight loss drug costs.
Source(s):
Health Policy in 2026 (KFF)
Tags: #ALL
Match Day results put spotlight on interventional cardiology’s workforce woes
Interventional cardiology’s second Match Day saw dozens of fellowship positions remain unfilled due to insufficient candidates. This highlights ongoing workforce shortages in the specialty despite the matching process being considered successful.
Source(s):
Match Day results put spotlight on interventional cardiology’s workforce woes (Cardiovascularbusiness)
Tags: #PROVIDER, #HOSPITAL
Reimagining the patient financial experience
A 2024 study found 72% of U.S. consumers cite affordability as the biggest challenge with large healthcare bills, and 47% report their well-being was negatively impacted by payment difficulties. Healthcare organizations are implementing three-pillar patient financial frameworks including radical transparency with real-time cost estimation from payer contracts, built-in affordability programs based on income and coverage, and self-service digital portals with human support for complex cases.
Source(s):
Reimagining the patient financial experience (HFMA)
Tags: #HOSPITAL, #PATIENT, #PAYER
Rural Health Providers Could Be Collateral Damage From $100K Trump Visa Fee
Trump’s new $100,000 H-1B visa fee (up from $5,000) is forcing rural hospitals to choose between paying fees equivalent to two lab technicians’ annual salaries or leaving critical positions unfilled. West River Health Services in North Dakota has received zero U.S. citizen applications for a lab tech position since late summer, despite over 30 foreign applicants available.
Source(s):
Rural Health Providers Could Be Collateral Damage From $100K Trump Visa Fee (Kffhealthnews)
Tags: #HOSPITAL, #PROVIDER
Study to Focus on Factors Influencing Brain Development in Kids With Congenital Heart Disease
The five-year CAN-DO study will compare neurodevelopmental outcomes in 300 pediatric patients across 20+ heart centers, evaluating children who received either surgical shunts or catheter-based interventions in their first month of life for congenital heart disease with ductal dependent pulmonary blood flow. Participants will undergo developmental assessments at 18 months and 3 years to determine which treatment approach better preserves brain development, as children with these conditions face higher risks for cognitive and behavioral delays.
Source(s):
Study to Focus on Factors Influencing Brain Development in Kids With Congenital Heart Disease (Goodmenproject)
Tags: #PATIENT, #PROVIDER, #DEVICE
The tech investments hospitals are making in patient experience
The article discusses hospital technology investments focused on improving patient experience, though the provided content excerpt only mentions a general need for better alignment between hospitals, public health groups, and payers to provide care while containing costs.
Source(s):
The tech investments hospitals are making in patient experience (Modern Healthcare)
Tags: #HOSPITAL, #PAYER, #PATIENT
Pope welcomes cardiologists to Vatican City
Pope Leo XIV addressed interventional cardiologists at Vatican City, describing their work as standing at the intersection of science, compassion and ethical responsibility. The Pope emphasized that cardiologists treat both the physical and metaphorical heart when providing patient care.
Source(s):
Pope welcomes cardiologists to Vatican City (Cardiovascularbusiness)
Tags: #PROVIDER
More interventional procedures may be coming to an ambulatory surgical center near you
The article discusses potential expansion of interventional cardiovascular procedures to ambulatory surgical centers, highlighting both current limitations and benefits for cardiologists and patients. However, the provided content appears to be only an introductory paragraph without specific facts, policy changes, or concrete details about which procedures or regulatory developments are being referenced.
Source(s):
More interventional procedures may be coming to an ambulatory surgical center near you (Cardiovascularbusiness)
Tags: #PROVIDER, #HOSPITAL
Some Health Plans Automatically Downcode Office Visit Claims
Several insurers including Cigna and Aetna are automatically downcoding evaluation and management (E/M) office visit claims to lower payment levels, with Cigna adjusting codes like 99215 to 99214 starting October 1st. A Texas physician reported 169 downcoded claims in 6 months but successfully appealed 66% back to original coding levels after submitting medical records. The AMA passed a resolution directing advocacy against these practices through regulatory and legal channels.
Source(s):
Some Health Plans Automatically Downcode Office Visit Claims (MedPage Today)
Tags: #PROVIDER, #PAYER
Improving Value-Based Care Depends on Better Payer-Provider Collaboration
Veradigm executive Amanda Banister discussed strategies for payers to lead value-based care implementation through improved collaboration with healthcare providers. The article appears to be sponsored content focusing on operational aspects of VBC partnerships.
Source(s):
Improving Value-Based Care Depends on Better Payer-Provider Collaboration (MedCity News)
Tags: #PAYER, #PROVIDER