Healthcare Reform

Tracking Legislative & Regulatory Change

From Congressional budget deals that tweak Medicare conversion factors to state bills redefining scope of practice, our healthcare reform posts explain how evolving statutes may influence medical decision-making, office work-flows, and payer negotiations. We connect the dots between headline votes and real-world clinic operations, spotlighting key provisions on payment models, telehealth flexibility, prior authorization, and interstate licensure compacts.

Analyzing Agency Rules & Guidance

The Centers for Medicare & Medicaid Services, the FTC, and state boards frequently publish rulemakings that affect reimbursement and compliance. Our articles summarize the practical pieces—effective dates, required disclosures, documentation standards—so physicians can adjust coding processes, update consent language, or join new alternative payment programs with minimal disruption.

Physician Autonomy & Practice Economics

Healthcare reform debates often pivot on consolidation, ownership restrictions, and value-based care incentives. We discuss how policies such as site-neutral payment proposals, surprise-billing regulations, and antitrust enforcement may influence the viability of independent practices versus hospital employment. Posts highlight contract clauses to watch, pitfalls in acquiring ancillary services, and strategies for sustaining revenue as payment structures evolve.

Practical Tips Rooted in Real Cases

Every commentary includes actionable insights—sample language for payer appeals when codes are retired, talking points for patient cost-of-care conversations after a benefit redesign, and checklists for updating compliance manuals. We draw on Dr. Jeffrey Segal’s dual perspective as surgeon and attorney to illustrate how one practice modified its financial policy after a change in balance-billing rules, or how another leveraged state innovation waivers to expand telehealth reach.

Key Topics We Discuss

• MACRA and QPP updates
• Interoperability & information-blocking rules
• Scope-of-practice expansion bills
• Federal price-transparency mandates
• State efforts to curb prior authorization delays