Our own analysis of the federal, state, and payer moves reshaping ABA, HCC, and Hospital revenue cycle. Sourced. Dated. Operator-focused. New articles published every month, drawn from the same research that powers our three monthly newsletters and our 52-state payer matrix.
For chain owners, COOs, and clinical directors. Federal directives, state Medicaid bulletins, payer policy shifts, and the operational consequences.
HB 696 banned telehealth-only assessments, locked out-of-state BCBAs out of NC Medicaid, and forced the Policy 8F redraft. NC is the Southeast playbook.
APR 30, 2026 · 4 MIN READ Federal CredentialingEvery state has 30 days to file a 2-year revalidation strategy. ABA was named as high-risk. $600M+ flagged across the multistate OIG audit series.
APR 23, 2026 · 4 MIN READ State Regulatory6% rate cut, 30-hour weekly cap, 4,000-hour lifetime cap, age-21 cliff October 1. Indiana is the bellwether for IL, OH, MI, KY.
APR 1, 2026 · 4 MIN READ Market · Payer RiskThree MCOs terminated Centria and Action Behavior Centers in one quarter. 1,000 children lost their provider. The playbook will spread.
MAR 5, 2026 · 4 MIN READFor medical group execs, ACO leaders, and MA-heavy practices. Risk adjustment, RADV, enforcement, and what plans will pay for in CY 2027.
Final +2.48% net update with the unlinked chart-review exclusion ending an estimated $7B annual capture practice. Two opposing signals for physician groups.
APR 6, 2026 · 5 MIN READ DOJ EnforcementUnitedHealth Q1 SEC filing acknowledged the criminal probe. Grassley's 50,000-page report dissects the capture playbook. Cigna already paid $172M.
FEB 1, 2026 · 5 MIN READ OIG GuidanceThe document names the operational playbooks of MA-aligned medical groups as compliance risk. Gateway Health audit: 81% unsupported diagnosis rate.
FEB 1, 2026 · 5 MIN READFor CFOs, VP Revenue Cycle, and Director PFS. Federal rules, mandatory bundles, and the compliance moves that protect FY27 cash.
The headline number for your board this quarter. 2.4% topline against 3.2% input cost growth. UCP pool drops 3.3% to $7.563B. Comments close June 9.
APR 10, 2026 · 4 MIN READ Mandatory Bundle90-day LEJR episode covering all Part A and Part B. Mandatory. Nationwide. CMS projects $725M savings over five years. This is your new fee schedule.
APR 10, 2026 · 5 MIN READ ComplianceApril 1, 2026 enforcement live. CMPs $3K to $5.5K per day. 65% of 3,764 hospitals reviewed mid-2025 received warning or CAP. Verify your MRF this month.
APR 1, 2026 · 4 MIN READAudits We Pass. Memberships We Hold.
