Podcasts about CMS

Wednesday, July 22, 2026 Today, RFK Jr pauses a billion dollars in Medicaid to California and Minnesota; Rep. Jamie Raskin is seeking documents related to Jeffrey Epstein's foreign contacts; IRS Chief Frank Bisignano spied on colleagues when he worked at JPMorgan; Trump and the OMB are violating the Impoundment Control Act by ignoring Congressional appropriations; an appeals court has overturned the release order of Mohsen Mahdawi; an appeals court has denied Peter Navarro's bid to overturn his contempt of Congress conviction; and a federal judge says Trump has to hand over his financials in discovery in the BBC libel case; plus Allison delivers your Good News. Thank You, Fast Growing Trees Get 20% off your first purchase  FastGrowingTrees.com/dailybeans The Daily Beans is proud to partner with Miles Taylor and our friends at DEFIANCE.org For a limited time, members of the Daily Beans community can receive a FREE 3-month full membership to DEFIANCE.org and gain access to one of the fastest-growing pro-democracy movements in America. Join here: https://www.defiance.org/beans Join The Daily Beans and give a gift today to ensure The Trevor Project can continue its crucial work in the face of continued challenges. Donate to The Trevor Project - Daily Beans Podcast The Latest Breakdown→ Epstein Survivor Recounts Meeting With Todd Blanche StoriesRFK Jr pauses $1bn Medicaid funding to California and Minnesota Raskin seeks documents into Jeffrey Epstein's foreign contacts - Live Updates - POLITICO IRS Chief Frank Bisignano Spied on Colleagues When He Worked at JPMorgan - WSJ Congress rejected some of Trump's proposed budget cuts. OMB is making them anyway. US appeals court raises prospect of re-arrest of pro-Palestinian advocate Mahdawi | Reuters Judge says Trump must hand over financial records to BBC - POLITICOGood Trouble Check your voter registration status →Vote.orgVoter Registration Deadlines - Vote.org →Help save Texas from Ken Paxton! →Urge Democrats to Oppose and Stop Trump's Crypto Corruption | Indivisible Guide →Defiance.org/beans →Show up for our Libraries - action.ala.org →Stand With Minnesota →ICE List  →iceout.org Good NewsGrassRoots Garden | Food for Lane County – Eugene, Oregon INDIVISIBLE KANSAS CITY sfcva.org dana-goldbergs-southwest-funnyfest Oct 9 -Email Dana@DanaGoldberg.com for sponsorship informationTickets for Dana Goldberg: Outrageous - Sep 23 - Den Theater - Chicago  →Share your Good News & Good Trouble - The Daily Beans →Beans Talk audio -beans-talk.simplecast.com →Email Dana LGBTQ Owned eating establishments in your area - hello@mswmedia.com Subject: “Dana's Project” Subscribe to the MSW YouTube Channel - MSW Media - YouTube Our Donation Links The Trevor Project - trevorproject.org/beans Blue Wave California - https://secure.actblue.com/donate/msw-bwc Donate to Public Citizen - https://citizen.org/beans/ Donate to It Gets Better / The Daily Beans Fundraiser Pathways to Citizenship link to MATCH Allison's Donationhttps://crm.bloomerang.co/HostedDonation?ApiKey=pub_86ff5236-dd26-11ec-b5ee-066e3d38bc77&WidgetId=6388736 Join Dana and The Daily Beans in support of Human Rights Campaign http://onecau.se/_ekes71National Security Counselors - Donate, ActBlue.com/donate/msw-bwc, WhistleblowerAid.org/beans Dr. Allison Gill - The Breakdown | Allison Gill, Mueller, She Wrote @muellershewrote.com - Bluesky, MSW & The Daily Beans Podcast @muellershewrote - Instagram, MSW Media - YouTube →Federal workers - email AG - fedoath@pm.me Dana Goldberg - Dana is on Patreon! At Dana's Dugout, @dgcomedy - Bluesky, @dgcomedy - IG, Dana Goldberg - Facebook,  DanaGoldberg.com More from MSW Media - Shows - MSW Media, Cleanup On Aisle 45 pod, The Breakdown | Allison Gill Reminder - you can see the pod pics if you become a Patron. The good news pics are at the bottom of the show notes of each Patreon episode! That's just one of the perks of subscribing! patreon.com/muellershewrote Listener Survey:http://survey.podtrac.com/start-survey.aspx?pubid=BffJOlI7qQcF&ver=shortFollow the Podcast on Apple:https://apple.co/3XNx7ckWant to support the show and get it ad-free and early?https://patreon.com/thedailybeanshttps://dailybeans.supercast.com/https://apple.co/3UKzKt0 Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

CMS-0057 and HTI-4 are reshaping prior authorization from both sides of the workflow: payer requirements and certified EHR readiness. This episode will break down what these regulations mean for providers, how they may change day-to-day prior authorization operations, and what questions organizations should be asking their vendors now.Brought to you by www.infinx.com

This week I Answer Listener Questions [powerpress]

Healthcare in America is stuck in a "sick care" model—we wait until people are already ill, then scramble to treat them. Dr. Gloria Winters, VP of Health Innovation at the YMCA of the USA, has spent the last year building something different: a community health operating system that pulls together your wearables, your medical records, and AI-driven insights into one place, so you actually know what to do with your health data instead of just staring at numbers. In this episode, she breaks down her "house" framework for the $5.6 trillion healthcare industry, why falls cost the country more than almost anything else, how she's working directly with HHS and the MAHA movement on preventive health policy, and why personal agency—not just data—is the missing piece in helping people actually change their behavior. If you've ever felt like your Apple Watch tells you everything except what you should actually do next, this conversation is for you. Key Takeaways:

July 17, 2026In this episode, Scott and Mark Painter provide their initial analysis of CMS's proposed 2027 Medicare Physician Fee Schedule and highlight the changes most likely to impact urology practices. The discussion covers the proposed conversion factor reduction, a significant new proposal to apply the multiple procedure payment reduction to E/M services billed with modifier 25, changes to G2211, updates to practice expense methodology, prostate biopsy coding revisions, telehealth proposals, and a substantial reimbursement increase for bulking agent injections. The team also shares practical insight into what these proposals could mean for physician compensation, practice operations, and future commercial payer policies. The key takeaway: while the rule is still only proposed, now is the time for urology practices to understand the changes, submit meaningful comments, and begin planning for what could be a very different reimbursement landscape in 2027. PRS Coding and Reimbursement HubAccess the HubBotox LCD AlertDownload the AlertFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

Welcome back to a special encore presentation of Turn on the Lights! As we continue our transition series, our new host, Dr. Philip, is revisiting some of the most impactful conversations from the archives. For this episode, he selected a standout discussion with Dr. Michelle Schreiber and Brenna Rabel, exploring how quality measures are developed, adopted, and implemented across Medicare and Medicaid programs. Summary: How do we decide what “good care” looks like, and who gets to choose the scorecard? In this episode of Turn on the Lights, Kedar Mate speaks with Dr. Michelle Schreiber of the Centers for Medicare & Medicaid Services and Brenna Rabel of Battelle about how quality measures are developed, adopted, and applied across Medicare and Medicaid programs. They explore why measurement is essential for accountability, patient choice, and improvement, while also acknowledging its vulnerability to politics, feasibility constraints, and “teaching to the test.” Using diabetes and sepsis as examples, they explain how performance cutoffs are established, why “all-or-none” measures often face resistance, and what makes complex measures difficult to report and score. The conversation also addresses efforts to reduce reporting burden, including CMS's shift from broader MIPS reporting toward MIPS Value Pathways and the expansion of digital quality measurement through FHIR-enabled eCQMs. They conclude with a forward-looking discussion on how artificial intelligence could reduce manual chart abstraction and advance quality measurement, particularly as patient-reported outcomes play a larger role in shaping the future of value-based care. Tune in to hear how measures shape what health systems prioritize, what gets improved, and what “value” could look like in the future. Resources: Connect with and follow Dr. Michelle Schreiber on LinkedIn. Follow CMS on LinkedIn and explore their website! Connect with and follow Brenna Rabel on LinkedIn. Follow Battelle on LinkedIn and explore their website! Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode of The Ross Simmonds Show, Ross shares why curiosity, execution, and continuous learning are becoming more valuable than traditional credentials in marketing, tech, and business. He breaks down how hiring managers, marketers, content creators, and business leaders can identify curious talent, build stronger teams, and stay relevant as AI, search, content distribution, and audience behavior continue to evolve. Key Takeaways and Insights: 1. Curiosity as a Career Advantage - Ross shares how growing up outside major tech hubs pushed him to use the internet as his mentor. - Curiosity helped him build a self-directed education across SEO, social media, content, SaaS, Reddit, LinkedIn, Quora, and startups. - The lesson: your location, background, or lack of connections does not limit your ability to learn and grow. 2. The Hiring Trap: Stacked Resume, Weak Execution - Ross warns leaders not to confuse impressive logos and credentials with real-world capability. - Some candidates know how to follow a playbook but struggle when asked to create or adapt one. - Hiring should focus on how people think, learn, ask questions, and solve problems—not just what appears on paper. 3. How to Identify Curious Marketers - Ask candidates what they are reading, what they are learning, and how they stay sharp in their craft. - Look for people actively tinkering with new tools, especially in the age of AI. - Curious marketers bring questions, data, and insights into conversations instead of relying on old playbooks. 4. Insight-Driven Marketing Decisions - Great marketers do not recommend SEO, CMS changes, or content strategies simply because they prefer them. - They gather data, ask about pipeline goals, conversion rates, customer lifetime value, and channel performance. - Curiosity turns marketing from guesswork into a structured, strategic process. 5. Where Curious People Spend Their Time - Curious professionals go where learning is happening: communities, subreddits, Discord servers, Slack groups, LinkedIn threads, and comment sections. - They engage in discussions, debate ideas, and test what they learn. - They do not just consume marketing tips—they apply them. 6. The Signals of a High-Curiosity Team Member - They research before making recommendations. - They reverse engineer why something worked instead of blindly repeating tactics. - They invest in courses, tools, and resources because they want to become better, not just get promoted. - They challenge leaders with data-backed thinking and fresh perspectives. 7. Why Curiosity Matters in the AI Era - AI is reshaping search, content distribution, GEO, AEO, and how buyers discover brands. - Channels that worked three years ago may not be enough today. - Marketers who stay curious will adapt faster as LLMs, Reddit, YouTube, short-form video, and emerging platforms shift the landscape. 8. Building a Learning Advantage - One to two extra hours of intentional learning per week can put you ahead of people doing none. - Those who invest more deeply in their skills create a larger competitive gap. - Continuous learning builds the taste, strategy, distribution skill, and human understanding needed to stay valuable. 9. Hiring for Curiosity and Growth - Leaders should ask candidates about newsletters, podcasts, tools, personal projects, and ideas they cannot stop thinking about. - Experience with tools like Claude, Perplexity, and ChatGPT can signal active experimentation. - Building a culture of curiosity helps teams stay adaptive, strategic, and ready for what comes next. —

One year after the passage of the Working Families Tax Cut Act (formerly known as the One Big Beautiful Bill Act), states and providers are continuing to grapple with the biggest changes to Medicaid in a generation. Harsh P. Parikh, Partner, Nixon Peabody LLP, Lloyd A. Bookman, Founding Partner, Hooper Lundy & Bookman PC, and Anne Winter, Senior Managing Director, FTI Consulting, discuss CMS' June 1 interim final rule related to work requirements, the multi-state lawsuit challenging that rule (Massachusetts v. Oz), new eligibility and coverage requirements, CMS' May 22 state-directed payment proposed rule, the current status of the Rural Health Transformation Program, and how states are responding to Medicaid cuts.Watch this episode: https://www.youtube.com/watch?v=NYIU0YqseHYWatch Harsh, Lloyd, and Anne's episode from December 2025: https://www.youtube.com/watch?v=0vIviLRddzI Watch Harsh, Lloyd, and Anne's episode from September 2025: https://www.youtube.com/watch?v=JDYg4KZwL0M Essential Legal Updates, Now in AudioAHLA's popular Health Law Daily email newsletter is now a daily podcast, exclusively for AHLA Comprehensive members. Get all your health law news from the major media outlets on this podcast! To subscribe and add this private podcast feed to your podcast app, go to americanhealthlaw.org/dailypodcast.Stay At the Forefront of Health Legal EducationLearn more about AHLA and the educational resources available to the health law community at https://www.americanhealthlaw.org/. 

Every career has an origin story, and for longtime CMS leader Lorraine Doo, it begins with the Attachments Rule on her very first day at the agency. In this episode, Lorraine reflects on the evolution of healthcare interoperability—from EDI transactions to APIs, FHIR, and today's digital health ecosystem—sharing behind-the-scenes insights into the policy decisions, collaborations, and regulatory milestones that have shaped modern health IT, along with her perspective on the challenges and opportunities that still lie ahead.

Fraud risks in Medicare Advantage, which now covers more than half of all Medicare beneficiaries, have been flagged as a top priority for government agencies. With that in mind, Rachel Rose, JD, MBA, joins the 1st Talk Compliance podcast to bring her expertise in False Claims Act litigation to the discussion on how best to avoid these risks, or run afoul of the DOJ or CMS. Listen now for firsthand insight into how these cases actually unfold and what providers can do to protect themselves and their practices.

About this episode:   Between a growing aging population, the emergence of new technologies, and cuts to Medicaid spending, the landscape of American caregiving is shifting. In this episode: Researcher Jennifer Wolff walks through changes in caregiving trends, underscores the importance of more research on the topic, and highlights new programs that aim to support older adults and their caregivers. Guest:  Dr. Jennifer Wolff is an expert in policy relating to the care of persons with complex health needs and disabilities, the Eugene and Mildred Lipitz Professor in Health Policy and Management, and director of the Roger and Flo Lipitz Center to Advance Policy in Aging and Disability. Host:  Lindsay Smith Rogers, MA, is the producer of the Public Health On Call podcast, an editor for Expert Insights, and the director of content strategy for the Johns Hopkins Bloomberg School of Public Health.  Show links and related content:  About NHATS & NSOC—NHATS The Number Of Family Caregivers Helping Older US Adults Increased From 18 Million To 24 Million, 2011–22—Health Affairs Cognitive assessment & care plan services—http://Medicare.gov GUIDE (Guiding an Improved Dementia Experience) Model—http://CMS.gov America's Caregiver Crisis—Public Health On Call (July 2025) The Potential Impacts of Cuts to Medicaid—Public Health On Call (March 2025) Transcript information: Looking for episode transcripts? Open our podcast on the Apple Podcasts app (desktop or mobile) or the Spotify mobile app to access an auto-generated transcript of any episode. Closed captioning is also available for every episode on our YouTube channel. Contact us: Have a question about something you heard? Looking for a transcript? Want to suggest a topic or guest? Contact us via email or visit our website. Follow us: @‌PublicHealthPod on Bluesky @‌PublicHealthPod on Instagram @‌JohnsHopkinsSPH on Facebook @‌PublicHealthOnCall on YouTube Here's our RSS feed Note: These podcasts are a conversation between the participants, and do not represent the position of Johns Hopkins University.

Send us Fan MailWhen a teenager expresses suicidal thoughts to an AI chatbot, what happens next?In this clip from our episode “Who Sets the Rules for AI in Medicine?”, hosts David E. Williams and John Driscoll and Dr. John Whyte, CEO of the American Medical Association, break down why minors need stronger protections from AI chatbots than adults do, and why the line between a wellness app and a medical device matters more than the industry wants to admit.Listen to the full episode here

────────────────────────────────────────[00:02:58]Telegram Founder Durov: EU's "Child Safety" Surveillance Law Is Classic Banana Republic TacticsArrested in France for running a free speech platform, Durov warns the EU's chat control law allows warrantless snooping on millions of conversations; every tyrannical act is sold as protecting children.────────────────────────────────────────[00:07:18]LAPD Let Its Flock Contract Expire — Flock Secretly Shared Local Camera Data With Federal AgenciesFlock ran an unauthorized data-sharing pilot without local consent; Mountain View, Santa Cruz, and Hillsborough have also walked away.────────────────────────────────────────[00:15:22]Cato and Reason Said Big Tech Censorship Was Fine Because "Private Companies Can Do Whatever They Want"When government uses tech companies as its enforcement arm, it's fascism — the literal merger of corporate and government power.────────────────────────────────────────[00:23:03]Ron Paul: Trump Purchased Partial Ownership of ~30 Companies Using $27 Billion in Taxpayer MoneyGovernment picking winners distorts capital markets and enriches the Trump family; Knight calls it communist fascism.────────────────────────────────────────[00:26:42]Trump's 1990 Playboy Interview: He Praised the Tiananmen Square Massacre as "Showing the Power of Strength"China "almost blew it" but recovered by killing everybody — a good thing, he said; the authoritarian heart of the man building America's surveillance state.────────────────────────────────────────[00:51:33]Dr. James Miller: Hospitals Were "Killing Fields" — Unvaccinated Patients Treated as Dirty Plague RatsCorporate systems denied standard care to the unvaccinated; the 20% CMS bonus for COVID patients created a financial incentive to classify, harm, and kill.────────────────────────────────────────[01:09:14]Democrat Ed Markey's AI Agenda Would Force Universal Online Age Verification and Digital IDMarkey frames it as fighting big tech while partnering with it; both parties using AI as their tool of tyranny, fighting over who gets credit.────────────────────────────────────────[01:11:43]Thomas Massey: "We Won All the Damn Elections — What Are We Doing? Bankrupting the Country and Starting Wars"Trump's election fraud obsession is about his ego; Republicans will face a shellacking in November if they don't wake up.────────────────────────────────────────[01:16:06]Trump Threatens a 20% Toll on Ships Through the Strait of Hormuz — Iran Mocks It ImmediatelyPiracy — exactly what the Barbary pirates did; Iran and Oman, which border the Strait, are prohibited from charging tolls while the US plans to charge them.────────────────────────────────────────[01:22:10]Netanyahu Confirms Plans to Formally Merge US and Israeli Militaries — De Facto to De JureConverting US subordination to Israeli command into legal cover; ICC arrest warrants for Netanyahu preceded the US State Department moving to abolish the ICC. ──────────────────────────────────────── Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silver For 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code “KNIGHT” For high quality made in America products go to HomeSteadProducts.shop and use promo code “Knight” for 10% off your purchases Find out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-show Or you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-david-knight-show--2653468/support.

────────────────────────────────────────[00:02:58]Telegram Founder Durov: EU's "Child Safety" Surveillance Law Is Classic Banana Republic TacticsArrested in France for running a free speech platform, Durov warns the EU's chat control law allows warrantless snooping on millions of conversations; every tyrannical act is sold as protecting children.────────────────────────────────────────[00:07:18]LAPD Let Its Flock Contract Expire — Flock Secretly Shared Local Camera Data With Federal AgenciesFlock ran an unauthorized data-sharing pilot without local consent; Mountain View, Santa Cruz, and Hillsborough have also walked away.────────────────────────────────────────[00:15:22]Cato and Reason Said Big Tech Censorship Was Fine Because "Private Companies Can Do Whatever They Want"When government uses tech companies as its enforcement arm, it's fascism — the literal merger of corporate and government power.────────────────────────────────────────[00:23:03]Ron Paul: Trump Purchased Partial Ownership of ~30 Companies Using $27 Billion in Taxpayer MoneyGovernment picking winners distorts capital markets and enriches the Trump family; Knight calls it communist fascism.────────────────────────────────────────[00:26:42]Trump's 1990 Playboy Interview: He Praised the Tiananmen Square Massacre as "Showing the Power of Strength"China "almost blew it" but recovered by killing everybody — a good thing, he said; the authoritarian heart of the man building America's surveillance state.────────────────────────────────────────[00:51:33]Dr. James Miller: Hospitals Were "Killing Fields" — Unvaccinated Patients Treated as Dirty Plague RatsCorporate systems denied standard care to the unvaccinated; the 20% CMS bonus for COVID patients created a financial incentive to classify, harm, and kill.────────────────────────────────────────[01:09:14]Democrat Ed Markey's AI Agenda Would Force Universal Online Age Verification and Digital IDMarkey frames it as fighting big tech while partnering with it; both parties using AI as their tool of tyranny, fighting over who gets credit.────────────────────────────────────────[01:11:43]Thomas Massey: "We Won All the Damn Elections — What Are We Doing? Bankrupting the Country and Starting Wars"Trump's election fraud obsession is about his ego; Republicans will face a shellacking in November if they don't wake up.────────────────────────────────────────[01:16:06]Trump Threatens a 20% Toll on Ships Through the Strait of Hormuz — Iran Mocks It ImmediatelyPiracy — exactly what the Barbary pirates did; Iran and Oman, which border the Strait, are prohibited from charging tolls while the US plans to charge them.────────────────────────────────────────[01:22:10]Netanyahu Confirms Plans to Formally Merge US and Israeli Militaries — De Facto to De JureConverting US subordination to Israeli command into legal cover; ICC arrest warrants for Netanyahu preceded the US State Department moving to abolish the ICC. ──────────────────────────────────────── Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silver For 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code “KNIGHT” For high quality made in America products go to HomeSteadProducts.shop and use promo code “Knight” for 10% off your purchases Find out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-show Or you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-real-david-knight-show--5282736/support.

Terry tackles a growing compliance issue in telehealth: where the patient is located at the time of the visit. While physicians generally must be licensed or otherwise authorized to practice in the state where the patient is physically located, evolving payer policies and Medicare rules have added new layers of complexity. From commercial insurance requirements to CMS guidance on services provided outside the United States, Terry explains what providers need to know to remain compliant and avoid costly reimbursement pitfalls. Subscribe and Listen Find all of Terry’s official links in one place: https://www.terryfletcher.net/links The post Telehealth: Where the Patient is or Where the Provider is? appeared first on Terry Fletcher Consulting, Inc..

Read more from VPM News:  Frustration with McGuire drives both sides of 5th Congressional District primary  WATCH: Richmond Coliseum's days are officially numbered (YouTube)    Other links:  Cyclosporiasis Surveillance and Investigation (Virginia Department of Health)  Virginia needs more nurses. Training them requires more than adding classroom seats (WHRO)  Efforts to reform federal drug pricing program 340B continue with new report, proposed CMS rule (Virginia Mercury)  Documents: Former RPS facilities director was paid for six weeks after investigation due to rejected resignation (The Richmonder)  New Kent leaders poised to strike down proposed data center district (Richmond Times-Dispatch)*  ‘Oyez, oyez.' Supreme Court's last official crier is dead at 102. (The Washington Post)*  Virginia approves historical marker to the song that inspired a generation of rock stars (Cardinal News)  *This outlet uses a paywall.  Our award-winning work is made possible with your donations. Visit vpm.org/donate to support local journalism.

Got questions? Send Ericka a Text!Less than 1% of denied dental claims ever get appealed and insurance companies are counting on you to be in the other 99%. I walk you through the denial management mindset shift that changes everything: stop treating the third appeal like the edge of the map and start using the tools that actually hold payers accountable, including your state insurance commissioner for fully insured plans. We get practical and specific about what makes a denial “unreasonable” or “bad faith” and how to spot the pattern: benefits are active, eligibility is confirmed, documentation supports dental necessity, and the claim still comes back denied. I also explain why we start with state and federal laws before we obsess over codes, because language like prompt pay, network leasing, and silent PPO issues gives your conversations more weight. Then we clean up common risk areas by separating an honest mistake, a contract violation, and fraud, because mixing those up can put a practice in real trouble. From there, we talk tactics: why copy-and-paste appeal templates can work against you in a world where insurers use AI to review claims, and what to use instead. Think ICD-10 diagnosis codes, strong narratives, and patient-specific clinical details that make your claim defensible. Finally, I share documented enforcement examples, including a major fine tied to undisclosed “phantom” frequency limits, and why complaints to regulators compound over time. If you want a denial process that protects patients and stops leaving money on the table, listen all the way through, then subscribe, share this with your office team, and leave a review so more billers learn how to escalate the right way.Sources referenced in this episode:Appeal rate / upheld rate: KFF analysis of CMS data — fewer than 1% of denied ACA marketplace claims are appealed; insurers uphold ~56% of appeals (2023 data), 66% (2024 data). Medicare Advantage: ~57% of appealed denials overturned. (On air we used these instead of the "59% upheld because nobody appealed" framing, which conflated the appeal rate with the uphold-on-appeal rate.)Delta Dental of Washington: Washington State Office of the Insurance Commissioner fined Delta Dental + its health care benefits manager (Wyssta) $130,000 (Oct/Nov 2024) for, among other things, denying claims based on time/frequency limits not filed with or approved by the state; 7 service types and 50 billing codes had undisclosed limits. Triggered by consumer complaints. This is an actual regulatory fine.Self-funded vs. fully insured (the "federal path" mention): The commissioner regulates fully insured plans. Self-funded employer plans fall under federal ERISA law and route to the U.S. Department of Labor (EBSA) instead, not the state commissioner. This is covered in depth in the full denial management talk, not this episode. (Government and church plans are a further exception.)Cigna PxDx: 2023 class action (E.D. Cal.), citing ProPublica reporting — ~300,000 denials in two months, avg. 1.2 seconds per claim, "we literally click and submit." Court allowed the case to proceed March 2025 (abuse of discretion). This is litigation, not a fine — described on air as a lawsuit/court ruling.UnitedHealth nH Predict: Class action (D. Minn.) alleging a 90% error rate on the AI tool and that ~0.2% of policyholders appeal. Court ordered algorithm disclosure in 2026. Allegations in active litigation — stated as such on air.The "0.2% will appeal" motive appears in both the Cigna and UnitedHealth complaints as an allegation of intent. Interested in a Demo of Dentiq - The Billing Command Center? Get on the interest list here:https://4063-dentiq.systeme.io/waitlistGet your Dental Billing Toolkit Here:https://www.dentalbillingdoneright.com/the-dental-billing-toolkitDownload "The Most Underused Codes in Dentistry - And How to Get Them Paid" checklist here:https://docs.google.com/forms/d/e/1FAIpQLSfxnnfSlNd0NPhMoBWq-1D_xU5R8LS4xPhHNKIjfLQwStOUag/viewform?usp=headerSchedule a billing chat with Ericka:https://calendly.com/ericka-dentalbillingdoneright/30minEmail Ericka:ericka@dentalbillingdoneright.comEmail Jen:jen@dentalbillingdoneright.com

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we delve into the latest news and insights that are shaping the landscape of patient care and drug development. The U.S. FDA has expanded the label for Pfizer and Astellas' Padcev, in combination with Merck's Keytruda, to include all muscle-invasive bladder cancer patients. This significant regulatory update broadens access to a combination therapy that merges an antibody-drug conjugate with a PD-1 inhibitor, offering enhanced treatment options for patients unable to tolerate cisplatin, a common chemotherapy drug. The decision marks a pivotal step forward in providing more inclusive and effective treatment regimens for bladder cancer. In Scotland, Roche's Columvi has been endorsed by the Scottish Medicines Consortium for use in treating relapsed or refractory diffuse large B-cell lymphoma. This approval highlights the growing importance of bispecific antibodies in oncology, which can simultaneously engage two different antigens to enhance anti-tumor responses. Such innovations underscore the ongoing transformation of cancer treatment through combination therapies. Across the Atlantic, Health Canada has approved Clinuvel's Scenesse for erythropoietic protoporphyria (EPP), a rare condition causing extreme light sensitivity. Scenesse acts as a melanocortin receptor agonist, offering photoprotection and improving quality of life for those affected by this debilitating disorder. On the business front, Bayer's strategic partnership with Apollo has secured a €3 billion equity deal for its long-acting reversible contraceptives business. This move underscores a growing emphasis on women's health and contraceptive innovation. Likewise, CMS and Insilico's collaboration aims to harness artificial intelligence for CNS drug discovery, promising to accelerate drug development through AI-driven target identification. Clinical trials continue to reveal promising developments. Eisai's Etalanetug is showing potential in reducing tau tangle biomarkers in dominantly inherited Alzheimer's disease. Similarly, Eisai and BioArctic's Leqembi subcutaneous autoinjector demonstrates comparable efficacy to its intravenous counterpart, potentially improving compliance and accessibility for early Alzheimer's patients through less invasive administration methods. Financially, Apnimed is planning an IPO to support its sleep apnea pill's commercial launch, while Velogene Biotechnology has secured Series A funding to advance its gene-editing platform. These financial activities highlight ongoing investments in innovative solutions aimed at addressing unmet clinical needs. Yet, challenges persist as well. The FDA has rejected Hengrui and Elevar Therapeutics' combination treatment for hepatocellular carcinoma for a third time, emphasizing the difficulties of meeting regulatory standards and demonstrating efficacy. Additionally, Germany's new healthcare cost-saving law has doubled pharmaceutical rebate rates, sparking industry concern over potential impacts on profitability and innovation investment. The regulatory landscape continues to evolve with the FDA proposing streamlined registration processes under the "hub-and-spoke" model to enhance transparency and security within supply chains. Meanwhile, recent FDA transparency actions have led to the release of 14 drug rejection letters, underscoring ongoing challenges in securing approvals due to stringent regulatory requirements. Geographically, emerging biotech hubs like Basel and Beijing are gaining prominence as global talent hotspots due to their conducive environments for research and development collaboration. These regions are becoming increasingly attractive for biopharmaceutical innovation. Amid fierce competition in obesity management solutions, Lilly's launch of its oral GLP-1 receptor agonist Foundayo faces stiff competition from Novo Nordisk's Wegovy pill. The race reflects broader trends toward developing patient-centric therapies that offer convenience alongside therapeutic efficacy. Intellectual property strategies are also evolving as companies employ new patent tactics to maintain competitive advantages in crowded markets. Safety remains a top priority as exemplified by Lupin Pharmaceuticals' recall of contaminated eye drops, highlighting ongoing challenges in ensuring product safety. Lastly, advancements in wearable technology offer promising improvements in patient care; however, integration into clinical practice is met with infrastructural hurdles—a sentiment echoed by healthcare professionals surveyed by the AMA. Overall, these developments paint a complex picture of scientific innovation intersecting with regulatory evolution and strategic industry adaptations aimed at enhancing patient outcomes while navigating economic pressures. As the industry evolves, stakeholders must remain vigilant and adaptable to seize opportunities and address challenges effectively.Support the show

This week I Share An Update: Three Months After the Layoff [powerpress]

Learn the Top 10 Virtual Assistant roles that can help grow your agency—and claim 20 FREE hours with Hire Heroes for a limited time.  https://hireheroes.com/ In this episode of the Seven Figures Or Bust Podcast, Christian Brindle and Glen Shelton break down why one of the nation's largest Medicare Advantage carriers is suing CMS over its star ratings—and why every Medicare agent should pay attention. They also discuss the real reason carriers push Home Risk Assessments (HRAs), how Medicare Advantage star ratings impact billions of dollars in funding, and what these behind-the-scenes battles mean for agents, carriers, and beneficiaries. Plus, they explain how carrier decisions, CMS regulations, and legal challenges continue to shape the future of the Medicare industry. 

In this episode, Greg and Rob are joined by Ted Slafsky and Will Newton of 340B Report. They recap major developments in the first half of 2026 that have impacted the 340B community. They'll discuss recent Congressional activity, including a newly introduced 340B Program reform bill (SECURE 340B Act), trends in federal administrative agency policies from HRSA and CMS, and the evolution of various manufacturer actions within the 340B Program. In the intro, they discuss recent HRSA audit finding trends and highlight key provisions in the CMS 2027 OPPS proposed rule, including anticipated Medicare Part B reimbursement reductions for 340B hospitals.    Use “SPENDMEND25” to get a 25% discount on a subscription to 340B Report: https://340breport.com/subscribe/ Going to the 340B Coalition Summer Meeting? Come see us at booth #418.

July 10, 2026: Your daily rundown of health and wellness news, in under 5 minutes. Today's top stories: Bold adds Medicare-backed GLP-1 prescriptions to virtual weight management, pairing medication with strength training as CMS's new Bridge program cuts costs to $50/month UK startup Reformed raises $22M Series A after scaling to $70M revenue, embedding collagen and creatine into coffee and matcha to upgrade existing habits Whoop hires former Nike CMO DJ van Hameren to lead global marketing ahead of a potential IPO, broadening beyond athletes past three million subscribers More from Fitt: Fitt Insider breaks down the convergence of fitness, wellness, and healthcare — and what it means for business, culture, and capital. Subscribe to our newsletter → insider.fitt.co/subscribe Work with our recruiting firm → https://talent.fitt.co/ Follow us on Instagram → https://www.instagram.com/fittinsider/ Follow us on LinkedIn → linkedin.com/company/fittinsider Reach out → insider@fitt.co

Send us Fan MailEighty-one percent of physicians are already using AI in practice, more than double the rate from just three years ago. The tools are moving faster than the rules, and nobody has agreed on who gets to write them.Dr. John Whyte, CEO of the American Medical Association, joins hosts David E. Williams and John Driscoll to discuss why the medical community needs to lead the conversation on AI guardrails rather than wait for Washington to catch up, and why the most urgent regulatory question right now involves AI chatbots in mental health, where one in six American adults are already using them with no meaningful oversight in place.

The Vince Coakley Radio Program | Friday, July 11th, 2026. Hour 1 Segment 1 – Show rundown Segment 2 – CMS school admin and leadership in desperate need of change | Modern Educational System is "Rotten" Segment 3 – WBT text line talks Mitch McConnell and CMS issues Segment 4 – Mitch McConell latest Hour 2 Segment 1 – Faith Focus Friday - Idolatry Segment 2 – WBT text line with Vince Segment 3 – James Talarico viral clip Segment 4 – This Day in History See omnystudio.com/listener for privacy information.

July 10, 2026In this episode, Scott, Mark, and Dr. Ray Painter break down CMS's latest updates to facility reimbursement for kidney stone procedures, including the revised C9761 code, the new C8014 code, and the payment implications for hospitals and ambulatory surgery centers. The discussion explains how suction-integrated ureteroscopes and suction-enabled access sheaths are now reimbursed, why physicians should understand facility payment even though their professional fee does not change, and how these updates may influence conversations with hospitals and ASCs about adopting new technology. The team also reviews the proposed 2027 payment changes and emphasizes the importance of aligning clinical decision-making with facility economics to expand patient access to innovative stone treatment technologies. PRS Coding and Reimbursement HubAccess the HubBotox LCD AlertDownload the AlertFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

Wenn ihr das hier lest, ist stayforever.de in neuem Glanz online. Die alte, schon auf dem letzten Loch pfeifende Wordpress-Seite ist Geschichte, nur das Forum ist übriggeblieben. Die neue Seite ist ein Eigenbau, kein vorgefertigtes CMS, von uns und für uns gebaut. Sie hat viele schöne Features, vor allem aber enthält sie unter der Haube eine komplette Membership-Plattform, sie kann Podcasts und andere Inhalte ausspielen, Mitgliedschaften und Abos verwalten, Paymentfunktionen übernehmen, und so weiter. Alles aus einer Hand, alles DSGVO-konform gehostet in Deutschland. Warum das nötig war, was am Ende den Ausschlag gab und wie ein Kaffeegespräch plötzlich zum Megaprojekt wurde, erzählen wir in dieser Folge – zusammen mit Jo und Paul, die die Plattform programmiert und designt haben. Achtung: Wir schalten die Mitgliedschaften auf Patreon, Steady und Youtube nicht ab, das ist alles weiterhin möglich. Wir schreiben euch nichts vor, aber wir glauben, dass wir mit der neuen Plattform ein besseres Angebot machen können. Wer sich für einen Wechsel entschließt, muss auch nichts aufgeben: Wir rechnen bereits bezahlte Zeit auf Patreon/Steady an, wenn ihr direkt zu uns wechselt. Reinhören lohnt sich – vielleicht nicht nur für alle Stay-Forever-Fans und -Unterstützende, sondern für jeden, der wissen will, was es bedeutet, sein eigenes kleines Podcast-Imperium technisch neu aufzuziehen.

In this episode of the HVAC Know It All Business Edition Podcast, co-hosts Gary McCreadie and Furman Haynes from WorkHero sit down with Brynn Cooksey Sr, CEM, CMS. He is the Founder of Air Doctors Heating & Cooling and HVAC U (Building Scientists). He discuss the business side of home performance contracting and explains how contractors can build highly profitable businesses by focusing on diagnostics, customer education, and measurable results. The discussion explores customer qualification, maintenance retention, team training, operational systems, and the financial benefits of delivering complete solutions instead of simple equipment replacements. Brynn also shares practical advice for business owners looking to scale their companies through better processes, stronger customer relationships, and a commitment to quality. Brynn a leading training organization focused on HVAC, building science, and home performance. With experience in both utilities and contracting, Brynn has become a respected educator and industry leader, helping thousands of contractors improve their technical knowledge, business operations, and customer outcomes through data-driven solutions.   Expect To Learn: - Why not every homeowner is the right customer for your business - How home performance testing creates trust and supports premium pricing - The connection between quality installations, customer retention, and referrals - How Brynn trains employees to embrace building science principles - Why bigger-ticket projects can improve profitability and efficiency - The role of processes, CRMs, and administrative systems in scaling a business - Key hiring and financial lessons for contractors looking to grow sustainably   Timestamps: 00:00 - Introduction 00:55 - Finding the Right Customers for Long-Term Success 02:10 - Building Customer Loyalty That Lasts for Generations 05:47 - Turning Expertise Into a Repeatable Business Model 08:08 - Creating a Training Culture That Scales 09:59 - Building Processes That Make Quality Consistent 10:33 - Why Bigger Tickets Create Better Business Outcomes 12:37 - Unlocking Revenue Beyond Equipment Replacement 13:19 - The Hidden Cost of Oversized Equipment 17:56 - Financial Lessons Every Contractor Needs to Learn 18:47 - Closing Thoughts   Follow our Guest Brynn Cooksey Sr, CEM, CMS: LinkedIn: https://www.linkedin.com/in/theairdoctor/ Instagram: https://www.instagram.com/theairdoctor313/    Company LinkedIn: Air Doctors Heating & Cooling: https://www.linkedin.com/company/airdoctorshvacservice/  HVAC U (Building Scientists): https://www.linkedin.com/company/hvac-ubuildingscientists/    Company Website:  Air Doctors Heating & Cooling: https://www.airdoctorshvacservice.com/  HVAC U (Building Scientists): https://www.hvactrain.com/  Company Instagram:  Air Doctors Heating & Cooling: https://www.instagram.com/airdoctorshvac  HVAC U (Building Scientists): https://www.instagram.com/hvac_university     Follow Gary McCreadie: LinkedIn: https://www.linkedin.com/in/gary-mccreadie-38217a77/  Website: https://www.hvacknowitall.com  Facebook: https://www.facebook.com/people/HVAC-Know-It-All-2/61569643061429/  Instagram: https://www.instagram.com/hvacknowitall1/    Follow Furman Haynes:  LinkedIn: https://www.linkedin.com/in/furmanhaynes/  WorkHero: https://www.linkedin.com/company/workherohvac/  Instagram: https://www.instagram.com/workhero__/

In this episode, Laura Dyrda, Vice President, Editor-in-Chief, Becker's Healthcare, discusses proposed CMS changes to the 340B program, site-neutral payment policies, and what they could mean for hospital and ASC finances. She also shares insights on shifting hospital expense trends, including rising drug and supply costs, and how health system leaders are adapting their strategies.

Send us Fan MailFerroptosis, an iron-dependent cell death pathway driven by lipid peroxidation; chronoferoptosis, in which chronic stress sensitizes neurons gradually.TOPICS DISCUSSED:Cell Death Pathways: Apoptosis proceeds through regulated steps with surface “eat me” signals that enable non-inflammatory clearance by phagocytes, whereas ferroptosis and related pathways release cellular contents that can amplify local damage and inflammation.Ferroptosis Discovery: Work on glutamate toxicity in neuronal cell lines first identified a glutathione-depletion pathway termed oxytosis; parallel studies in cancer cells renamed and generalized it as ferroptosis to highlight iron's catalytic role.Lipid Peroxidation: Polyunsaturated fatty acids in membranes are oxidized non-enzymatically when ferrous iron reacts with hydrogen peroxide in the Fenton reaction, generating hydroxyl radicals that produce toxic lipid peroxides and reactive carbonyls that modify proteins.GPX4 & Glutathione: Glutathione peroxidase-4 is an enzyme that reduces lipid peroxides within membranes and requires glutathione as cofactor; depletion of either component removes this critical line of defense.Chronoferoptosis: Nine-day treatment of differentiated neuronal cells with chronic iron or glutathione synthesis inhibitor reduced GPX4 protein, raised basal lipid peroxidation, and increased cell death after addition of otherwise sublethal secondary stressors.Protective Compounds: Screening identified flavonoids such as fisetin and sterubin plus synthetic molecules J-147 and CMS-121 that block lipid peroxidation directly or indirectly and, in several cases, also raise glutathione levels.Human Disease Evidence: Postmortem brain tissue from Alzheimer's and Parkinson's patients shows elevated lipid peroxidation markers and altered iron handling in vulnerable regions; similar changes appear in animal models of multiple diseases.Dietary & NRF2 Links: Compounds that activate the NRF2 transcription factor, including sulforaphane from broccoli and certain flavonoids, upregulate antioxidant enzymes including GPX4 and may support long-term cellular resilience.ABOUT THE GUEST: Pamela Maher, PhD is a research professor at the Salk Institute for Biological Studies in La Jolla, California. Her laboratory studies ferroptosis mechanisms in neurodegenerative diseases and works to identify compounds that inhibit iron-dependent lipid peroxidation. Support the showSupport my work:Good Chemistry: Personalized, science-based health consulting. Work with Dr. Nick Jikomes directly.Affiliate Partners: Visit this link to see my affiliate partners and get discounts codes for products & services to support health.For all the ways you can support my efforts.

"Strapi est sûrement le CMS le plus personnalisable" Le D.E.V. de la semaine est Pierre Burgy, CEO chez Strapi. Pierre revient sur l'évolution de Strapi, né à l'époque où les devs rêvaient de tout faire en JavaScript, jusqu'à son passage à l'échelle dans l'ère de l'AI et des coding agents. Il partage comment la vision open source et la personnalisation extrême sont devenues des atouts stratégiques, sans négliger la stabilité technique. On explore l'impact des LLM sur la notion même de CMS et les choix architecturaux nécessaires pour les nouveaux usages. Entre anecdotes terrain et perspectives, cet épisode dessine le futur du content management. Et surtout l'annonce d'un produit révolutionnaire pour les dev et les équipes marketing: Fimo.Chapitrages00:00:56 : Aux origines de Strapi00:02:38 : Naissance d'un CMS Node.js00:06:40 : Trouver la bonne architecture00:09:09 : Plugins et personnalisation00:10:36 : Face à WordPress00:13:55 : Sécurité et API fermées00:14:43 : Les fondations techniques00:18:48 : Le défi TypeScript00:24:31 : CMS à l'ère des LLM00:27:16 : La réponse IA de Strapi00:33:15 : Pourquoi les CMS restent utiles00:37:34 : Fimo, le système d'exploitation de sites00:44:50 : LLM et crédits intégrés00:46:41 : Vers des sites autonomes00:51:21 : Le pari du harness engineering00:53:30 : Recommandation et conclusion Liens évoqués pendant l'émission Chaine Youtube Javascript MasteryVidéo "How Senior Engineers Actually Build With AI in 2026"

The Centers for Medicare & Medicaid Services is expanding access to GLP-1 medications through the new Medicare GLP-1 Bridge program. Eligible beneficiaries will be able to receive the medications for $50 a month, though not everyone enrolled in Medicare will qualify. Subscribe to our newsletter to stay informed with the latest news from a leading Black-owned & controlled media company: https://aurn.com/newsletter Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Show DescriptionChris & Dave have been challenged to not talk about AI this episode - do they succeed? How do I optimize tracking pixels in my web app, what's the best book on CMS and authoring experiences, picking the best tooling in Rails that won't be obsolete, SPF, DNS, and D-Marc, adding dark mode to a website, and dealing with good old fashioned F.A.R.T. Listen on WebsiteWatch on YouTubeLinks Vizio accidentally made the best dumb TV on the market | The Verge Window: queueMicrotask() method - Web APIs | MDN Jake Archibald on the web browser event loop, setTimeout, micro tasks, requestAnimationFrame, ... - YouTube Designing Content Authoring Experiences Ruby on Rails: Accelerate your agents with convention over configuration Secure AI Agent & User Authentication | Auth0 next.js TanStack | The open-source application stack for the web. RedwoodSDK: A simple framework for humans Heroku | The Cloud Application Platform For Developers Push your ideas to the web | Netlify Agentic Infrastructure - Vercel Astro Jekyll • Simple, blog-aware, static sites | Transform your plain text into static websites and blogs Nuxt: The Full-Stack Vue Framework SendGrid Email API and Email Marketing Campaigns | Twilio Email · The email API for developers who ship the rest of the message too — Bird Cloudflare: Build for the agent era CSS Analytics - Project Wallace Flash of inAccurate coloR Theme (FART) | CSS-Tricks

This week I Talk About Optimizing the Wrong Things! [powerpress]

Did you know that CMS estimates three million Medicare beneficiaries aren't enrolled in the government's Medicare Extra Help program but could benefit from it? In this episode of the Agent Survival Guide, we see what this program is and how it can help your clients.   Read the text version   Get Connected:

Jon Hartley and Dr. Oz along with his two deputies discuss running the Centers for Medicare & Medicaid Services (CMS) which administers the major federal government healthcare programs within the US Department of Health and Human Services (HHS), tackling Medicaid and Medicare fraud across the nation, healthcare changes in the One Big Beautiful Bill (Working Families Tax Cuts Act), lowering pharmaceutical drug prices through most favored nation (MFN) deals and TrumpRx, and integrating AI and technology into CMS workflows. Recorded on June 11, 2026. ABOUT THE SERIES Each episode of Capitalism and Freedom in the 21st Century, a video podcast series and the official podcast of the Hoover Economic Policy Working Group, focuses on getting into the weeds of economics, finance, and public policy on important current topics through one-on-one interviews. Host Jon Hartley asks guests about their main ideas and contributions to academic research and policy. The podcast is titled after Milton Friedman‘s famous 1962 bestselling book Capitalism and Freedom, which after 60 years, remains prescient from its focus on various topics which are now at the forefront of economic debates, such as monetary policy and inflation, fiscal policy, occupational licensing, education vouchers, income share agreements, the distribution of income, and negative income taxes, among many other topics. For more information about the podcast, or subscribe for the next episode, click here.

In this episode of the HVAC Know It All Business Edition Podcast, co-hosts Gary McCreadie and Furman Haynes from WorkHero sit down with Brynn Cooksey Sr, CEM, CMS, the Founder of Air Doctors Heating & Cooling and HVAC U (Building Scientists). They explore how building science can transform an HVAC business. Drawing from his background in the utility industry, Brynn explains why many contractors focus too much on equipment and not enough on understanding the home as a complete system. The conversation covers energy audits, customer trust, home performance testing, pricing strategies, and the business advantages of moving beyond simple equipment replacements. Brynn also shares practical advice for contractors looking to differentiate themselves through diagnostics, education, and problem-solving. Brynn is a nationally recognized educator in the HVAC industry. Before entering the HVAC business, Brynn worked in the power and utilities sector, where he gained a deep understanding of energy generation, distribution, and efficiency. Today, he is known for helping contractors adopt building science principles, home performance testing, and customer-focused solutions that improve comfort, indoor air quality, and energy efficiency.   Expect To Learn: - The business case for offering energy audits and home performance services - How building science can increase revenue while reducing marketing costs - The step-by-step process behind a professional home energy audit - Why testing and diagnostics lead to better customer outcomes than equipment-focused sales - How contractors can gradually adopt building science without overwhelming their business - The difference between competing on speed versus competing on quality and expertise   Timestamps: 00:00 - Introduction 00:56 - The Thermostat Scheduling Debate 03:22 - Lessons from the Utility Industry 04:43 - Solving Energy, Comfort, and Indoor Air Quality Problems 05:47 - The Business Case for Building Science 08:28 - Where Contractors Should Start with Home Performance 11:14 - Why Homeowners Need More Than Equipment Quotes 13:01 - Inside a Professional Energy Audit 14:03 - Identifying Hidden Problems Before Testing Begins 18:18 - Building a Business Around Quality Instead of Speed   Follow our Guest Brynn Cooksey Sr, CEM, CMS: LinkedIn: https://www.linkedin.com/in/theairdoctor/ Instagram: https://www.instagram.com/theairdoctor313/    Company LinkedIn: Air Doctors Heating & Cooling: https://www.linkedin.com/company/airdoctorshvacservice/  HVAC U (Building Scientists): https://www.linkedin.com/company/hvac-ubuildingscientists/    Company Website:  Air Doctors Heating & Cooling: https://www.airdoctorshvacservice.com/  HVAC U (Building Scientists): https://www.hvactrain.com/    Company Instagram:  Air Doctors Heating & Cooling: https://www.instagram.com/airdoctorshvac  HVAC U (Building Scientists): https://www.instagram.com/hvac_university     Follow Gary McCreadie: LinkedIn: https://www.linkedin.com/in/gary-mccreadie-38217a77/  Website: https://www.hvacknowitall.com  Facebook: https://www.facebook.com/people/HVAC-Know-It-All-2/61569643061429/  Instagram: https://www.instagram.com/hvacknowitall1/    Follow Furman Haynes:  LinkedIn: https://www.linkedin.com/in/furmanhaynes/  WorkHero: https://www.linkedin.com/company/workherohvac/  Instagram: https://www.instagram.com/workhero__/  

Q3 has arrived and preparations for AEP 2027 are starting. Listen to find out what agents selling Medicare should focus on during this time of year.   Read the text version   Get Connected:

Every CMS-1500 claim includes a set of certifications, attestations, and legal statements printed on the reverse side of the form. While these statements may seem like standard administrative language that has been around for decades, they carry significant legal and compliance implications. In this episode, Terry breaks down what these certifications actually mean and why every claim submitted is a legal representation that the services billed were properly documented, medically necessary, accurately coded, and provided in compliance with applicable regulations. She also explains why understanding these attestations is essential to maintaining a strong revenue cycle management (RCM) workflow, reducing compliance risk, and helping organizations avoid costly payer audits. Subscribe and Listen Find all of Terry’s official links in one place: https://www.terryfletcher.net/links The post CMS-1500 Form Compliance appeared first on Terry Fletcher Consulting, Inc..

Neal Shah, Shareholder, Polsinelli, speaks with Scott Strickland, Attorney, Hall Render Killian Heath & Lyman PC, about what the Center for Medicare and Medicaid Innovation (CMMI) has been doing in the health care space. They discuss examples of some of the more prominent CMMI models, the distinction between CMMI models and traditional CMS models, health care industry responses to CMMI models, what the next generation of CMMI models looks like, and the different approaches that CMMI has taken regarding provider payment obligations. Scott co-authored an article for Health Law Connections on this topic. From AHLA's Regulation, Accreditation, and Payment Practice Group.Watch this episode: https://www.youtube.com/watch?v=bQysibh0rhYRead Scott's Health Law Connections article: https://www.americanhealthlaw.org/content-library/connections-magazine/article/34b68117-81e2-4c7f-9258-245198a69107/CMMI-and-the-Next-Generation-of-Alternative-Paymen Learn more about AHLA's Regulation, Accreditation, and Payment Practice Group: https://www.americanhealthlaw.org/practice-groups/practice-groups/regulation-accreditation-and-payment Essential Legal Updates, Now in AudioAHLA's popular Health Law Daily email newsletter is now a daily podcast, exclusively for AHLA Comprehensive members. Get all your health law news from the major media outlets on this podcast! To subscribe and add this private podcast feed to your podcast app, go to americanhealthlaw.org/dailypodcast.Stay At the Forefront of Health Legal EducationLearn more about AHLA and the educational resources available to the health law community at https://www.americanhealthlaw.org/. 

Chris Kline is co-founder of BitcoinIRA, building a full-service platform that enables individuals to invest in cryptocurrency for retirement through secure, turnkey solutions and strategic industry partnerships, nationwide investor access. Top 3 Value Bombs 1. Financial markets are evolving, and getting even a small allocation into crypto can significantly improve long-term portfolio performance. 2. Holding crypto inside a retirement account eliminates capital gains taxes on trades, preserving more of your investment gains. 3. Simplicity wins; using turnkey platforms and expert guidance helps investors avoid costly mistakes and confidently enter the crypto space. Check out the website bitcoinira.com to open an account and explore crypto investing. Take advantage of special offers and referral rewards - Bitcoin IRA Sponsors HighLevel - The ultimate all-in-one platform for entrepreneurs, marketers, coaches, and agencies. Learn more at HighLevelFire.com. 50 Days - Join JLD on his free '50 Days to Something' video series on YouTube and create something special in 50 days. Revenued - Built for small business owners who need fast, flexible access to working capital, without relying on your personal credit score. Apply now at Revenued.com/fire. Framer - A website builder that offers real-time collaboration, a robust CMS with everything you need for great SEO, and advanced analytics that include integrated A/B testing. Get started building for free today at Framer.com/fire. For 30 percent a Framer Pro annual plan use code FIRE.

This week I Interview Howard Spaeth [powerpress]

We break down Medicare's brand-new GLP-1 Bridge Program and explain why headlines are both true and incomplete. We lay out the real eligibility rules, the $50 copay promise, and the smarter questions to ask so you and your clinician can find the right coverage pathway. • why Medicare historically excludes weight loss medications and what changed with modern obesity medicine • what the GLP-1 Bridge Program is designed to do and why it is not universal coverage • the $50 copay detail and why office visits labs and deductibles can still affect total cost • who does not qualify because another Medicare Part D pathway may already apply • the three eligibility “doors” based on BMI and specific risk conditions • which GLP-1 medications are included at the time of recording and the planned program timeline • how to prepare for an appointment and the exact phrasing that helps your clinician pick the right route • why checking CMS and staying current matters as rules evolve You can send us an email, you can find us on Threads, follow us on Instagram, or leave us some fan mail.Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply.Support the showProduction and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RNArtwork Rebrand and Avatars:Vantage Design Works (Vanessa Jones) Website: https://www.vantagedesignworks.com/Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qrOriginal Artwork Concept: Olivia Pawlowski

 Need help scaling your business? Check out Hire Heroes and claim your first 20 hours of virtual assistant support completely free:  https://hireheroes.com/  In this episode of the Seven Figures Or Bust Podcast, Christian Brindle and Glen Shelton dive into the latest Medicare headlines, including controversial comments from HHS and CMS leadership, a proposed $5,000 Medicare out-of-pocket cap, AHIP season discussions, and what these developments could mean for agents across the country. Plus, they share behind-the-scenes stories, business lessons from the Savannah Bananas phenomenon, and insights on scaling your agency the right way.  

Discussing the Pros and Cons of Global Chat and Hero Journey, reddit's reaction to each, and introducing a new mod. Links:r/ClashofClans Global ChatRadio Clash Global ChatClan Chat CM Interview (when published)Timestamps:(00:00) Intros and Lost Episode(02:03) Global Chat, Recruiting, and Adoption Rates(17:04) What the Hero Journey Is, and Isn't(27:03) Reddit has been Clowns, and How We Drove Away the CMs(35:13) Capital Farm Bot Problems(40:27) Listener Questions(51:32) Goodbye Sam & ShoutoutsYou can support us by using creator codes "coolrick" and "spencer" for your in-game purchases in any supercell game or platform.  About the Podcast: Reddit Talks Clash is a Clash of Clans podcast hosted by Liam, Sam, Spencer, and Rick: four mods of r/ClashOfClans. We cover Clash of Clans updates, balance changes, community news, esports, and more. Join us live for recordings on the Official Clash of Clans Discord: ⁠www.discord.gg/clashofclans⁠. Select “Podcasts” as an interest when joining, or ask a mod how to get notifications for live episodes. As part of Supercell's Creator Program, we bring you official Clash of Clans news, event breakdowns, and community discussions every week. ⁠⁠Find more information here. (https://creators.supercell.com/en/supercell-partner)  ⁠⁠ #supercreator

A 30 to 40 percent Medicare cut just hit the doctors who keep your local hospital running, and the policy meant to stop hospital monopolies is accelerating them instead. John Birkmeyer, president of the medical group at Sound Physicians and a former Dartmouth health services researcher, discusses the KevinMD article "Medicare practice expense cuts will hurt patients." You'll hear how CMS quietly slashed the practice expense portion of Medicare payments for the first time in 20 years, hitting independent hospitalists, ER doctors, and critical care groups with net cuts of 6 to 10 percent. You'll learn why CMS aimed at hospital-owned practices but instead pulled the rug from under the independent groups already operating at 2 to 4 percent margins, why rural hospitals will struggle hardest to staff, and how the resulting consolidation drives up prices for every patient. You'll also hear what CMS could fix in its 2027 rule and why physician advocacy now is the only correction available before more independent practices fold. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Classes are out at CMS for the summer, but tensions over education policy and administration linger. Superintendent Dr. Crystal Hill was put on paid leave while the board investigates administrative oversight matters. We'll discuss the latest from CMS, look back at some of the significant events of the last school year, and examine the growing pushback against classroom technology.

Imagine being penalized for delivering good care to your frailest patients. Medicare's quality scoring program was built for healthy outpatients, not the elderly residents of nursing homes, but it is the system doctors who round in skilled nursing facilities are forced to play. Steve Buslovich, a physician executive and geriatrician, discusses the KevinMD article "How Medicare's MIPS impacts skilled nursing facilities and clinicians." You'll hear how MIPS metrics conflict with the five-star quality measures facilities must report, why tightly controlling A1C in frail elders can cause harm, and how documentation discrepancies between physicians and facilities create financial and legal risk for both. You'll learn which nine measures actually fit post-acute long-term care, why CMS needs frailty-based quality metrics, and how AI and synced EHRs can pull data automatically so clinicians can get back to the bedside. If you practice in or operate a nursing home, this conversation names the rules of a game you didn't choose to play. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

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Listener feedback, more long-term data on the TAVR/SAVR question, population prevalence of valvular heart disease in the US, and a CMS proposal to expand TAVR coverage are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Listener Feedback ICD Trends and Outcomes: 15-Year Analysis https://doi.org/10.1093/europace/euag110 MADIT-RIT https://www.nejm.org/doi/full/10.1056/NEJMoa1211107 II More Long Term Data on TAVR vs SAVR PARTNER 2 Trial https://www.jacc.org/doi/10.1016/j.jacc.2026.03.169 10-Year Outcomes of SAPIEN 3 TAVR or SAVR in Intermediate-Risk Patients https://doi.org/10.1016/j.jacc.2026.03.170 TAVR at a Decade: Editorial https://doi.org/10.1016/j.jacc.2026.04.042 EVOLUT Trial https://www.jacc.org/doi/10.1016/j.jacc.2026.02.5063 Updated 5-year Outcomes of TAVR vs SAVR in AS https://heart.bmj.com/content/early/2026/02/11/heartjnl-2025-327092 NOTION Trial https://doi.org/10.1093/eurheartj/ehae043 PARTNER 3 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2509766 NOTION 2 Trial https://academic.oup.com/eurheartj/article/45/37/3804/7673297 TAVR vs SAVR Editorial : https://academic.oup.com/eurheartj/advance-article-abstract/doi/10.1093/eurheartj/ehag407/8708044 III The PREVUE-VALVE Study PREVUE-VALVE Study https://www.jacc.org/doi/10.1016/j.jacc.2026.02.5137 IV CMS has Proposed New Coverage for TAVR CMS Proposal Document https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?proposed=Y&ncaId=321 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net