Wednesday, June 10, 2026

CMS posted three separate notices seeking public comment on agency information collection activities. The notices signal upcoming changes to administrative and data-reporting requirements for Medicare and Medicaid providers. Two documents request comment on proposed collections; the third covers a submission for OMB review. The specific forms and burden estimates are not detailed in the notices. Watch for Federal Register notices that follow these pre-publication steps; they will contain the concrete changes and will open formal comment periods, typically 60 days. Track OMB Control Numbers 0938-XXXX for the final rulemakings.

Diagnostic Imaging published an analysis of the 2026 Medicare Physician Fee Schedule changes for radiology. The article outlines specific shifts in valuation for imaging services, including adjustments to practice expense inputs and updates to the global period for certain interventional radiology codes. The piece highlights the combined impact of the 2026 conversion factor cut and specialty-specific RVU changes on net reimbursement. It notes specific CPT families affected, urging practices to model revenue impact by service line. The article advises radiology groups to review their payer mix, as commercial payers often follow Medicare's lead on valuation changes but with a several-month lag. Monitor your major commercial contracts for policy updates referencing the 2026 PFS.

Illinois has finalized new Medicaid contracts for its HealthChoice program, selecting Humana and several other insurers. The multi-year awards, valued in the billions, will determine the payer landscape for a significant portion of the state's Medicaid population. The contract shift means practices serving Illinois Medicaid patients should expect enrollment and credentialing requests from new health plans. Operational workflows, including prior authorization portals and claim submission addresses, will change for affected patient panels. Monitor the Illinois Department of Healthcare and Family Services for the official go-live date and transition plan.

A new state report has classified 13 rural hospitals in Virginia as being at immediate risk of closure. The analysis cites persistent financial pressures from thin operating margins, high fixed costs, and payer mix challenges as the primary drivers. Hospital closures in these communities would force patients to travel longer distances for care, disrupt referral networks for specialists, and increase the financial strain on remaining facilities due to uncompensated care. Independent practices in these regions should assess their local hospital's stability and begin contingency planning for potential disruptions to lab, imaging, and inpatient referral partners.

Availity launched a new resource aimed at preventing claim denials before submission, marking an industry pivot away from post-claim denial management. The platform uses data analytics to flag potential issues with coding, medical necessity, and payer-specific edits prior to claim transmission. The tool integrates with EHRs and practice management systems, offering real-time alerts for missing authorizations, incorrect modifiers, or mismatched diagnosis codes. This proactive approach targets a core driver of revenue cycle leakage. While the tool is vendor-specific, the shift signals a broader RCM trend: payers and clearinghouses are investing in upstream error prevention to reduce the volume and cost of adjudication.