Wednesday, June 17, 2026

CMS released a proposed decision memo to expand Medicare coverage for Transcatheter Aortic Valve Replacement (TAVR). The memo, open for public comment, aims to update national coverage determinations based on clinical evidence and patient outcomes. Practices with cardiology and cardiothoracic surgery programs should monitor the CMS docket for the final rule, as expanded coverage could shift procedural volume and billing patterns for these high-cost, complex interventions.

CMS has issued updated guidance on telehealth billing for Rural Health Clinics (RHCs). The changes clarify billing requirements and modifier use for distant site telehealth services provided by RHC practitioners. Administrators at RHCs should review the new CMS transmittal and audit their 2026 claims to ensure compliance. Failure to align with the updated guidance risks claim denials and potential RHC status review during cost report audits.

A pending billing policy change could increase out-of-pocket costs for pregnancy and maternity care. While the specific payer and rule are not detailed, the signal indicates a shift that will affect patient financial responsibility for OB-GYN services. Practices should prepare patient financial counseling teams to explain new cost-sharing structures and verify coverage details for prenatal and delivery services starting in the next benefit year. Monitor payer bulletins for the official policy announcement and effective date.

Sturgis Hospital in Michigan announced it will close all departments and services on June 19, 2026. The closure, attributed to years of financial struggles, displaces patients and eliminates a key access point in a rural community. This follows a pattern of rural hospital distress amplified by thin margins, staffing shortages, and payer mix challenges. For neighboring independent practices, expect an influx of displaced patients seeking primary and outpatient care, along with increased pressure on emergency departments. Review your patient panels for Sturgis Hospital referrals and prepare your scheduling and intake teams for potential new patient volume from the surrounding area.