Saturday, March 21, 2026

CMS published a correcting amendment to the CY 2026 Physician Fee Schedule final rule, fixing practice expense RVUs for 10 CPT codes including radiation therapy (77402, 77407, 77412) and remote monitoring codes (99454, 98977). The corrections recalculate PE RVUs based on updated OPPS APC payment rates and geometric mean costs. The 3.26% rate increase for all physicians remains intact.

Procode AI launched with $4M in seed funding (Story Ventures, CHAP Health Ventures) and acquired The Auctus Group, the top RCM company for plastic surgeons. Their Coding Copilot reads operative reports and maps them to billing codes, claiming coders work 90% faster. Added $2M ARR in five months post-acquisition. Serves 300+ providers.

Turquoise Health closed a $40M Series C led by Oak HC/FT and a16z. Positioning: the operating system for healthcare pricing and payments. Uses hospital MRF data to build pricing intelligence. Separate from but adjacent to billing — Turquoise supplies the pricing data, billing teams process the claims.

A Santa Barbara surgeon publicly alleged that UnitedHealthcare's denial and delay tactics contributed to a patient's "preventable death." Patient had severe peripheral arterial disease, underwent amputation, then was denied in-network skilled nursing facility placement. Surgeon's team was promised a physician appeal within 72 hours — received no response for five days despite continuous calls. Patient's condition deteriorated while awaiting insurer approval for post-operative care.

CEOs of UnitedHealth, CVS, Cigna, Elevance, and Ascendiun testified before two House committees on January 22. UnitedHealth denied a stroke patient's hospitalization in Washington state, calling it "medically unnecessary." A California family fought United for five years over coverage for their three-year-old's rare bladder tumor treatment. ACA premiums doubled or tripled for millions after enhanced subsidies lapsed at end of 2025. Andrew Witty earned $26.3M in 2024; David Cordani earned $23.2M (279x his median employee).