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Medicaid Enrollment Heat Map
Relevant to OBBBA driven coverage disruption. This heat map shows US states with potential for largest…
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Medicare Advantage Prior Authorization Transparency Not Required – Infographic
CMS suspended the MA prior authorization transparency rules that would have given RCM directors plan-level denial…
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340B Rebate Model RFI: What FQHCs Need to Know and Submit Before April 20
HRSA’s 340B Rebate Model RFI closes April 20. For FQHCs, the proposed shift from upfront discounts…
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Before and After: Medicaid Work Requirements
The One Big Beautiful Bill Act (OBBBA) doesn’t just change Medicaid policy — it restructures the…
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When CMS Pulled Back MA Prior Authorization Transparency Rules, RCM Directors Lost More Than Data
CMS suspended the MA prior authorization transparency rules that would have given RCM directors plan-level denial…
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⚠️ RCM Alert
Quality Payment Program 2025 Performance data deadline 3.31.26
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CMS-0057-F Is Now Law: How the New Prior Authorization Timeline Requirements Change Your Denial Workflow
CMS-0057-F is in force as of January 1, 2026. Payers must now issue PA decisions within…
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OBBBA Is Law: Your FQHC Implementation Countdown for Medicaid Work Requirements and the Coming Eligibility Denial Surge
Public Law 119-21 is enacted law with a January 1, 2027 implementation deadline. Here is what…
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FQHC Encounter-Based Billing: The Top 5 Denial Triggers and How to Eliminate Them
FQHC encounter-based billing creates a distinct denial risk profile that most billing teams aren’t fully prepared…
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Under Construction
Bear with me as I work through some design concepts. The posts will be coming!