PYA Webinar Recast

CMS FY 2027 proposed rule changes could significantly affect reimbursement, quality reporting, and operational planning across hospitals and post-acute care settings. In this episode of Healthcare Regulatory Roundup, PYA's Kathy Reep and Carine Leslie break down the most important payment updates, quality program revisions, and compliance considerations providers should evaluate now. The...

This episode covers CMS enforcement activity and the downstream impact of Risk Adjustment Data Validation (RADV) audits on healthcare providers participating in Medicare Advantage. PYA experts explain how Medicare Advantage payments flow from CMS to health plans and providers, how risk adjustment drives reimbursement, and why provider documentation plays a critical role in compliance. The...

This episode covers the impact of the One Big Beautiful Bill Act (OBBBA) on Medicare DSH and the 340B drug pricing program. PYA presenters explain how new Medicaid eligibility requirements may affect hospital reimbursement, patient mix, and program eligibility, and outline strategies for accurately capturing Medicaid eligible days. The discussion also reviews recent 340B developments, including...

How hospitals can prepare for financial risk under the CMS TEAM model by turning claims data into actionable performance insights. This session explains how to quantify downside exposure, identify variation across episodes, and use dashboards and governance structures to drive measurable improvement.

This episode outlines the top 10 healthcare compliance risk areas managers need to know in 2026. PYA compliance leaders, Shannon Sumner, Miriam Murray, and Katie Croswell, discuss vendor oversight, cybersecurity and data breaches, artificial intelligence governance, digital transformation, healthcare real estate, EMTALA compliance, exclusion screenings, and reimbursement pressures. The session...

This episode examines how healthcare organizations can mitigate compliance and financial risk while conducting revenue integrity audits. PYA Principal Valerie Rock and Manager Kimberly Campbell walk through the auditing and monitoring cycle, with a focus on defensible sampling, documentation, and interpretation of results. The discussion covers: Probe audits versus statistically valid random...

This episode reviews new proposed rules, payment models, and regulatory guidance affecting healthcare organizations in early 2026. PYA Principals Martie Ross and Kathy Reep break down recent legislative activity, Medicare and Medicaid policy updates, and regulatory changes providers should be tracking as the year begins. Topics include: Medicare telehealth extensions Healthcare extenders Medicaid...

This episode examines key policy, payment, and program changes shaping rural healthcare in 2026. PYA Principals Martie Ross and Kathy Reep discuss major federal initiatives affecting rural providers, including the Rural Health Transformation Program, Medicare telehealth policy, and Medicaid developments. The session also addresses Medicare Advantage oversight, 340B drug program compliance, price...

This episode of PYA's Healthcare Regulatory Roundup continues a two-part discussion on the 2026 Medicare Physician Fee Schedule Final Rule, with a focus on telehealth, global payment reforms, and skin substitutes. The conversation walks through what stays in place for telehealth, including face-to-face visit requirements, and highlights new codes related to telebehavioral health and global...

This episode of PYA's Healthcare Regulatory Roundup examines the 2026 Medicare Physician Fee Schedule Final Rule and its impact on physician reimbursement, payment calculations, and quality reporting. The discussion covers updates to the conversion factor under MACRA, budget neutrality adjustments, new efficiency adjustments affecting work RVUs, and revisions to the practice expense...