Tag: Medicare

AI-generated illustration of an open stainless steel surgical instrument tray and a small brass balance scale on a walnut counter against a dark navy wall, representing the 2027 Medicare hospital outpatient and ambulatory surgical center payment rule.

CMS 2027 OPPS/ASC Final Rule: A Florida Physician Guide

CMS finalized the 2027 hospital outpatient and ASC payment rule on November 4. ASCs and hospitals get 2.3% on January 1, about 600 procedures join the ASC list, 340B drugs fall to ASP minus 28%, and non-contrast imaging at older off-campus hospital sites drops to the fee schedule rate. What it means for Florida surgeons, ASC owners and hospital-employed physicians, alongside Florida's office surgery suite standards due the same day.

AI-generated illustration of a brass and glass hourglass with sand running beside a stethoscope with navy tubing on a walnut desk against a dark navy wall, representing the 2027 Medicare Physician Fee Schedule taking effect January 1.

CMS 2027 Fee Schedule Final Rule: Florida Physician Guide

CMS finalized the 2027 Medicare Physician Fee Schedule on November 4. The conversion factor falls to $32.63 (down 2.31%) on January 1, same-day visits with 0-day procedures are paid at 80%, and G2211 becomes modifier B1. What it means for Florida practices billing through First Coast, with worked examples and steps to take before January.

AI-generated illustration of a small brass balance scale beside a coiled stethoscope with navy tubing on a walnut desk against a dark navy wall, representing the DOJ False Claims Act self-disclosure pilot.

DOJ False Claims Self-Disclosure Pilot 2026: A Florida Guide

The Justice Department and HHS will settle self-disclosed False Claims Act violations at 1.25 to 1.6 times the amount owed through April 22, 2027. What the pilot covers, why it does not reach Florida Medicaid claims under section 68.082, and what Florida practices should do now.

AI-generated illustration of an empty physician exam room with a deep navy privacy curtain drawn halfway, a bare walnut exam stool, a cream exam table and a single stethoscope with muted red tubing hanging from a brass hook, late-afternoon light through window blinds

177,000 Floridians Lose Medicaid: A Physician Guide 2026

On October 1, H.R. 1 ended Medicaid for refugees, asylees and other lawfully present immigrants, and KFF estimates nearly 177,000 Floridians will lose coverage, more than any state. Wrongful terminations are already hitting children and green card holders, with ACA subsidies ending January 1 and Medicare terminations starting in January 2027. Six things a Florida physician should do now.

AI-generated illustration of a physician's white coat and navy stethoscope hanging on a brass hook on a navy wall in an empty Florida exam room, with striped morning light from window blinds, a walnut cabinet and a muted red chair

CMS to Quadruple Payment Suspensions: Florida Guide 2026

CMS says provider payment suspensions will quadruple in six months, HHS has handed CMS its own exclusion authority, and Florida AHCA is terminating Medicaid providers and forcing revalidation. What the rules allow, and six things a Florida physician should do now.

AI-generated illustration of a stethoscope and a lit battery lantern on a bare walnut desk in a Florida physician's office, with half-open storm shutters and wet palm fronds behind rain-streaked glass after Hurricane Isaias.

Hurricane Isaias Waivers: A Florida Physician Guide 2026

HHS declared a public health emergency for Florida after Hurricane Isaias. The Section 1135 waiver, retroactive to October 6, changes licensure, EMTALA, Stark, HIPAA, and Medicare Advantage rules for physicians in 27 counties. Here is what each order does.

AI-generated illustration of reading glasses, a stethoscope and a white orchid on a bare walnut exam room table, with a red cardigan draped over a chair behind

Memory Complaints in the Florida Exam Room: A Physician Guide

Florida has 580,000 residents over 65 living with Alzheimer's dementia and 17 state memory clinics. Most memory complaints will be worked up first by the physician the patient already sees. What Medicare already requires at the wellness visit, how CPT 99483 pays for the full evaluation, and what the FDA-cleared p-tau217 blood test can and cannot do.