Wednesday, September 30, 2026 - Updated Daily
Wednesday, September 30, 2026 - Updated Daily
Medicare Advantage SNF denials are frequently reversed on appeal while plans shrink coverage. The dual squeeze hits skilled nursing census and revenue. This is part II of a three-part series. Part I is here: https://rhislop3.com/medicare-advantage-regional-pullbacks/…
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…
Senior living is a long-duration business. A resident who moves into a Life Plan or CCRC community at the start of retirement may remain on the same campus for a decade or more, receiving everything…
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 executive, consultant, and author covering post-acute care, senior living, and the economics behind both - for 30+ years.
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