Tuesday, July 28, 2026

CMS is collecting public comments on a revised form that will require all providers to submit their National Provider Identifier and CMS Certification Number during enrollment. The agency is seeking new authority to validate this information. If finalized, this would formalize a more rigorous front-end screening process, potentially leading to application delays or denials for mismatches or invalid numbers. This is part of a broader CMS crackdown on enrollment fraud and administrative errors. The comment period is the next step; monitor the final rule for implementation dates.

The American College of Radiology has published an analysis of the proposed 2027 Medicare Physician Fee Schedule, outlining specific valuation cuts for imaging services. The analysis shows reductions for certain MRI and CT codes, driven by budget neutrality and the proposed 2.26% conversion factor cut. The organization warns these cuts will exacerbate existing access gaps for imaging services. Practices should model the impact on their most commonly billed radiology CPT codes using the ACR's tables to prepare for potential 2027 revenue changes. The final rule will be published in November 2026.

ArentFox Schiff reports the 2027 Physician Fee Schedule proposed rule includes a requirement for 340B hospitals to report claims data for drugs purchased under the discount program. This move is part of CMS's effort to collect comprehensive data on 340B utilization and spending, which has been contentious. The agency has not specified how it will use the data, but industry analysts expect it will inform future policy on 340B reimbursement, particularly for Medicare Part B drugs. The comment period for the proposed rule is open until September 2026. Monitor the final rule for any changes to the reporting mandate.

The Transparency Coalition reports state legislatures have passed at least 14 new laws in 2026 aimed at regulating the use of artificial intelligence in healthcare. These laws primarily focus on algorithm transparency, bias audits, and patient notification requirements. This trend follows federal scrutiny of AI-based prior authorization and clinical decision tools by Medicare Advantage plans. The regulatory patchwork creates compliance complexity for vendors and provider organizations that deploy AI across state lines. Track final state-level implementation dates, as they may require changes to vendor contracts or patient-facing disclosures.

A Pennsylvania federal judge denied Cigna's motion to dismiss a lawsuit alleging the insurer illegally tracked patient data through its online portal. The suit claims Cigna used tracking tools to monitor user behavior without adequate consent, potentially violating state privacy laws. This ruling allows the case to proceed to discovery. While the suit is consumer-facing, it signals heightened legal scrutiny of payer data practices that could influence future consent requirements for provider-facing portals and data-sharing agreements. No direct billing impact exists, but it is a marker of payer data governance risk.