Well-intended overinterpretation or misinterpretation of regulatory requirements can increase workload, lead to “over-documentation,” and contribute to clinician and staff burnout. As the Chief Medical Officer of Intellicure, for 25 years I have had to deal with...
CMS has released the proposed CY 2026 Physician Fee Schedule. CMS is proposing to continue to pay for CTPs that have a biologic license agreement (BLA) using Average Sales Price (ASP) +6%. However, all other products would be paid at $125.38/cm2 (prior to the...
CMS says scammers are sending Medicare providers and suppliers phishing fax requests for medical records and documentation, falsely claiming to be part of a Medicare audit. This notice was posted on the CMS website: “CMS has identified a fraud scheme targeting...
HHS Secretary Kennedy, CMS Administrator Oz Secure Industry Pledge to Fix Broken Prior Authorization System | CMS Medicare Advantage, Medicaid Managed Care, Health Insurance Marketplace® and commercial insurance plans now cover covering nearly 80% of Americans. These...
Today the Department of Justice (DOJ) held a press conference led by Dr. Mehmet Oz, the Administrator of the Centers for Medicare and Medicaid (CMS) and officials from the DOJ, announcing the results of its 2025 National Health Care Fraud Takedown. The takedown...
