Thursday, May 14, 2026

CMS has enacted a six-month moratorium on new Medicare enrollment for all hospice and home health agencies. The suspension takes effect immediately and halts the approval of new applications. Existing providers continue to be reimbursed, but no new providers can join the program for half a year. This administrative action will freeze expansion in these sectors and likely concentrate patient volume among current participants. Practices that planned to expand into or contract with new home health or hospice providers this summer must adjust their referral networks now.

Bionano Genomics reported first-quarter revenue growth and highlighted the activation of new CPT billing codes for its optical genome mapping tests. The company's financial results are directly tied to the recent implementation of these codes, which create a clearer reimbursement pathway for complex genetic analyses. This signals a successful code adoption for a niche diagnostic technology. Billing teams in genetics and oncology should verify that their systems are updated with the latest CPT codes for optical genome mapping to ensure clean claims for these services.

A new survey reveals widespread physician skepticism toward recent insurer pledges to reform prior authorization processes. Despite public commitments from UnitedHealthcare, Aetna, and others to reduce PA burdens, most clinicians do not believe these promises will materialize into meaningful workflow changes. This trust gap indicates that administrative staff should not anticipate a near-term reduction in authorization submission volume. Billing operations must continue to prioritize robust prior authorization tracking and follow-up as a core denial-prevention strategy, regardless of payer announcements.

Federal officials are deferring $1.3 billion in Medicaid payments to California due to suspicions of fraud in the state's managed care program. The suspension, announced by HHS, follows investigations into questionable billing and eligibility practices among Medi-Cal managed care plans. California officials have disputed the action, calling it politically motivated. The withheld funds could strain the state's safety-net system and delay payments to Medicaid providers if the freeze extends. This signals a heightened federal focus on Medicaid program integrity under the current administration, with other states likely facing increased scrutiny.