Friday, September 18, 2026 - Updated Daily
Friday, September 18, 2026 - Updated Daily
Recent healthcare billing fraud cases show similar conduct moving across bill coding, DME, telemedicine, and product billing. Read the provider-level analysis….by Reginald Hislop, III Earlier this week I wrote about CMS barring eleven medical…
CMS announced a $3.4 billion medical equipment supplier fraud scheme involving 11 suppliers and claims for deceased beneficiaries. Here is what it means….by Reginald Hislop III On September 8, 2026, CMS announced that it…
Medicare Advantage plans are paid through risk adjustment. The government sends each plan a fixed monthly amount per enrollee, and that amount rises when the enrollee’s record contains certain diagnosis codes. The system assumes sicker…
Healthcare reform is not a single bill. It is three separate changes moving through the federal system at once, and only one of them touches a skilled nursing facility’s day-to-day operations directly. Operators who treat…
Medicare Advantage vs traditional Medicare is no longer a beneficiary-choice discussion alone. It is a market-structure issue affecting referral patterns, hospital utilization, post-acute length of stay, network access, risk-bearing arrangements, and the financial viability of…
The report that CMS is withholding $1B in Medicaid payments from California and Minnesota is not merely another Washington-versus-state-capital political skirmish. It is a reminder that Medicaid is financed through a conditional partnership, and federal…
Healthcare executive, consultant, and author covering post-acute care, senior living, and the economics behind both - for 30+ years.
No noise - just what changed in healthcare policy and economics, and why it matters to your operation.