Bottom Line Up Front: The Centers for Medicare & Medicaid Services (CMS) has finalized the 2027 Medicare Physician Fee Schedule, bringing reimbursement reductions for most physicians alongside significant changes to billing, practice expense calculations, and certain care delivery models. While some provisions create new reimbursement opportunities, physician practices should begin evaluating how the changes
HHS Compounded Peptide Policy: What Healthcare Providers Should Know
Bottom Line Up Front: The U.S. Department of Health and Human Services (HHS) has announced a new policy easing federal enforcement restrictions on the compounding of six peptides, including BPC-157 and TB-500. The move could expand access to treatments that have grown increasingly popular despite limited clinical evidence supporting their safety and effectiveness. However
Stop Corporate Takeovers of Physicians Act Explained
Bottom Line Up Front: The Stop Corporate Takeovers of Physicians Act would create federal restrictions on physician practice ownership and MSO control in an area historically governed primarily by state law. The bill would also address physician non-competes, employment protections, and control over practice operations.
Medicare Fraud Crackdown: What Recent Enforcement Actions Tell Providers
Last summer, I wrote about the Department of Justice (DOJ) and Department of Health and Human Services (HHS) launching a joint False Claims Act Working Group focused on Medicare fraud enforcement. At the time, the government identified several priority enforcement areas, including Medicare Advantage risk adjustment, kickbacks, drug and device arrangements, and the use of
The State-by-State State of Physician Non-Competes
A 50-state guide to physician non-compete laws, including states that ban or restrict physician non-competes and major changes affecting physicians in 2026.
Continue Reading The State-by-State State of Physician Non-Competes
Aetna Agrees to Pay $117.7 Million to Settle False Claims Act Allegations Over Medicare Advantage Upcoding
Last summer, I wrote about the DOJ and HHS relaunching their joint False Claims Act Working Group, with Medicare Advantage risk adjustment fraud listed as one of its top enforcement priorities. The Aetna settlement announced earlier this month is a direct example of that initiative delivering results.
What Happened
Aetna has agreed to pay $117.7
AI in the Exam Room: What WVU Medicine’s Abridge Rollout Means for Physicians
Artificial Intelligence continues to move quickly into the clinical workflow.
WVU Medicine recently announced that it is expanding its use of Abridge, an AI-powered transcription platform designed to generate clinical documentation during patient encounters. What began as a small pilot program in 2025 has now grown to more than 1,200 physicians, nurse practitioners, and physician
CMS Announces New Mandatory Payment Model Targeting Cardiologists for Heart Failure Care
The Centers for Medicare & Medicaid Services (CMS) recently announced a new payment initiative that will require certain cardiologists to participate in a value-based reimbursement model focused on heart failure care. This program, known as the Ambulatory Specialty Model (ASM), is scheduled to begin January 1, 2027 and will run through December 31, 2031.
The
Quick Instagram and TikTok Updates for Physicians and Medical Practices
Healthcare regulations are constantly evolving, and staying informed is critical for physicians, practice managers, and healthcare professionals.
In addition to in-depth articles here on Med Law Blog, Tucker Arensberg healthcare attorney Adam Appleberry provides regular legal updates and practical guidance on social media:
• Instagram: @the.doctors.lawyer
• TikTok: @thedoctorslawyer
Through short, focused videos and posts
CMS Launches ASC Prior Authorization Demo for Certain “High-Risk” Procedures: What ASCs and Surgeons Need to Know
The Centers for Medicare & Medicaid Services (CMS) has been using prior authorization for selected Hospital Outpatient Department (OPD) services for several years as part of its broader effort to curb improper payments and unnecessary utilization. In late 2025, CMS expanded that approach into the Ambulatory Surgical Center (ASC) setting through a new Prior Authorization