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On this episode of Diabetes Connections In the news… The FDA approves a new indication and health benefit for Mounjaro, lots of CGM news including an update on Medicare coverage for people who don't use insulin and a new study about using CGM when you don't have diabetes, metformin and aging, statins and type 2, and did you know there was a Dolly Parton diabetes connections? That and much more... Check out all of our events like Moms' Night Out and Club 1921 here. Announcing Community Commericals! Learn how to get your message on the show here. Learn more about studies and research at Thrivable here Please visit our Sponsors & Partners - they help make the show possible! Omnipod - Simplify Life All about Dexcom All about VIVI Cap to protect your insulin from extreme temperatures The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com On this episode of Diabetes Connections In the news… The FDA approves a new indication and health benefit for Mounjaro, lots of CGM news including an update on Medicare coverage for people who don't use insulin and a new study about using CGM when you don't have diabetes, metformin and aging, statins and type 2, and did you know there was a Dolly Parton diabetes connections? That and much more.. that's coming up right after this. (AD BREAK) Welcome! I'm your host Stacey Simms and this is an In The News episode.. where we bring you the top diabetes stories and headlines happening now. A reminder that you can find the sources and links and a transcript and more info for every story mentioned here in the show notes. Welcome to September! Want to let you know about a webinar I'm doing with Abbott later this month. That's Sept 23 at 7pm ET. We'll be talking about ketones, DKA and learn more about their dual CGM/ketone monitor that was just approved – more on that coming up. But please register – the link is in the show notes. So much going on over here – tomorrow night we have our Club 1921 in Charlotte, later this month Moms' Night Out Detroit/Bloomfield and in October we're going to Seattle. Please join us. More at d-c dot com slash events. Okay.. our top story this week: XX Another indication for Mounjaro – the FDA approved it to lower the risk of major adverse cardiovascular (CV) events (MACE), including CV death, non-fatal heart attack, or non-fatal stroke in adults with type 2 diabetes who are at high risk for these events. Mounjaro – the brand name of tirzepatide - is already approved as an adjunct to diet and exercise to improve blood sugar in adults and children 10 years of age and older with type 2 diabetes. The approval was based on results from the largest and longest tirzepatide study to date, enrolling more than 13,000 participants across 30 countries over more than four and a half years. In the trial, Mounjaro demonstrated non-inferiority to Trulicity (dulaglutide), a GLP-1 treatment with established cardiovascular benefit, with an 8% lower rate of cardiovascular death, heart attack or stroke (MACE-3). The estimated hazard ratio for time to first MACE was 0.92 (95.3% CI: 0.83, 1.01) for Mounjaro compared to Trulicity (dulaglutide). https://www.prnewswire.com/news-releases/fda-approves-lillys-mounjaro-tirzepatide-to-reduce-cardiovascular-risk-in-adults-with-type-2-diabetes-302862415.html XX The FDA approves the Libre Duo – the first device designed to continuously monitor both blood sugar levels and ketone levels in people with diabetes. The Libre Duo 10-Day Continuous Dual Glucose Ketone Monitoring System is now approved for those ages 2 and older. Until now, the agency said, people had to monitor ketone levels with separate tests that only provided a single measurement at one point in time. The new system combines blood sugar and ketone tests and monitors them continuously. Readings -- and alerts in case of dangerous trends -- are sent wirelessly to a smartphone app. The FDA previously granted "breakthrough device" status to the system, which is meant to expedite the device's development and review. https://www.upi.com/Top_News/US/2026/08/25/fda-oks-blood-sugar-ketone-monitor/5521787688375/ XX Diabetes tech firms Dexcom and Abbott are watching closely for a Medicare coverage expansion that could significantly broaden access to their glucose sensors. The Centers for Medicare and Medicaid Services is expected to expand Medicare coverage of continuous glucose monitors to people with diabetes who do not take insulin. Currently, coverage is limited to people with Type 1 or Type 2 diabetes who take insulin or have a history of problematic low blood sugar. Dexcom CEO Jake Leach told investors in a late July earnings call that the company expects to hear back from the CMS before the end of the year, with coverage going into effect in mid-2027. Dexcom presented results of a randomized, controlled trial earlier this summer at the American Diabetes Association's Scientific Sessions that it expects will support the CMS' decision. The 26-week study found that people who used a CGM had a larger hemoglobin A1C reduction than the control group and spent five more hours per day in a normal glucose range than the control group. https://www.medtechdive.com/news/dexcom-abbott-await-medicare-coverage-expansion-for-cgms/828775/ XX A new study suggests continuous glucose monitors (CGMs) may offer benefits for people with type 1 diabetes that go beyond improving blood sugar and reducing hypoglycemia. Researchers analyzed health records from more than 8,400 adults with type 1 diabetes receiving care through the Veterans Health Administration. Over one to four years of follow-up, people who started using a CGM had a 10% to 16% lower risk of death from any cause compared with those who did not use one. The association appeared strongest among people over age 65 and those who were not using insulin pumps. Researchers did not find meaningful differences based on A1C, race or ethnicity, or frailty. Importantly, this was an observational study using medical records, not a randomized clinical trial, so it cannot prove that CGM use directly caused the lower death rate. But the findings suggest CGM may have important long-term health benefits beyond glucose management.https://visualize.jove.com/42319755-continuous-glucose-monitoring-initiation-is-associated-with-reduced-mortality-in-older-onset-type-1-diabetes-patients-a-target-trial-emulation-study-within-the-veterans-health-administration XX We've been talking about people without diabetes using CGMs for a long time.. now a new study weighs in. Research published in JAMA finds that this wellness trend isn't helpful for people without a diabetes diagnosis. They found that the strongest evidence for CGM use is for people who are already living with diabetes, but not for those without the condition who use them for wellness purposes. It's also worth noting, though, that this new study is a narrative review. This means that the researchers drew their conclusions from the findings reported in several other studies. More randomized controlled trials would be necessary to see whether there are any meaningful health benefits of using a CGM if you don't have diabetes. Dower also warned that constantly monitoring your blood sugar when you don't have diabetes could lead to unintended health anxiety. In some cases, you may even make accidental lifestyle changes that could be harmful. "[Blood sugar] spikes may occur after meals, but if this leads someone to replace healthy food such as fruit with unhealthy food such as something high in fat but low in carbohydrate, the glucose information has done more harm than good," Dower said. https://www.verywellhealth.com/blood-sugar-monitor-for-people-without-diabetes-12058575 XX Could metformin somehow influence the biological processes that drive aging? A new review found evidence that metformin may affect several key features of aging, including how cells use energy, inflammation, cellular damage and even some changes in gene activity. Animal studies have shown longer lifespans or improvements in markers of biological aging, while some human studies have also found promising results. But researchers say there's still no proof that metformin actually slows aging or helps healthy people live longer. Most human research has involved people with diabetes or other health conditions, and one large trial found that while metformin helped prevent type 2 diabetes, it did not reduce cancer, cardiovascular disease or deaths. Researchers say larger clinical trials in people without diabetes are needed to determine whether metformin can truly extend healthy lifespan—or whether its benefits are primarily related to preventing and treating specific diseases. https://www.technologynetworks.com/drug-discovery/news/metformin-may-influence-longevity-through-the-gut-microbiome-and-epigenetic-changes-416035 XX More to come including more research on a spice thought to help diabetes, predictions about the number of people who may be living with type 1 in the years to come around the world, and a connection I didn't know about between diabetes and Dolly Parton. XX A compound found in turmeric may help protect blood vessels from some of the damage caused by Type 1 diabetes. In rats, curcumin reduced inflammation, improved cellular signaling, and restored vascular health to levels resembling those of nondiabetic animals. The results hint at a possible new way to reduce the long-term cardiovascular risks of diabetes, but human trials are still needed. Curcumin, the natural compound responsible for turmeric's vivid yellow color, is widely studied for its anti-inflammatory and antioxidant properties. https://www.sciencedaily.com/releases/2026/08/260824065543.htm XX New research estimates the number of people living with type 1 diabetes (T1D) worldwide will increase by 29% from 9.4 million in 2025 to 12.1 million in 2049. This will be presented at EASD, the Annual Meeting of The European Association for the Study of Diabetes (EASD) in Milan, Italy (Sept 28 – Oct 2 The USA will see an increase of over half a million, going from 1,492,825 to 2,055,235. The authors suggest that the reasons for the predicted high incidence and prevalence in 2049 in countries such as Australia, US, UK are likely to be a combination of genetics, environmental triggers and also high case detection rates (due to the good health care infrastructure here and in other HIC). Unlike previous estimates, the DIAMOND-T1D model takes historical patterns of insulin availability into account and aims to provide global, regional and country-specific estimates of T1D incidence, prevalence and mortality from 1900 to 2050. Although the majority of people with T1D live in high-income countries (HIC) and middle-income countries (MIC), the largest relative increase in the T1D prevalence is expected to occur in LIC as access to insulin, glucose monitoring and survival all improve in those countries. https://www.news-medical.net/news/20260828/Type-1-diabetes-cases-projected-to-increase-worldwide-by-2049.aspx XX Early initiation of statins after a diagnosis of type 2 diabetes was associated with a lower risk of dementia, according to a study published in The Lancet Regional Health – Europe. According to the Lancet Commission, nearly half of dementia cases could theoretically be prevented by eliminating 14 risk factors. "Detecting and treating high levels of low-density lipoprotein cholesterol (LDL-C) from midlife is one such highlighted risk factor," From Danish registers, researchers identified 132,585 statin-naive individuals who developed type 2 diabetes from 2006 through 2019, with follow-up until the end of 2021. Medical records were searched for diagnoses of all-cause dementia. A clone-censor-weight design was used to analyze dementia incidence in patients with no statin initiation within five years after diagnosis, in those with early statin initiation within one year and in those with late statin initiation between one and five years after diagnosis. https://medicalxpress.com/news/2026-08-early-statins-diagnosis-diabetes-dementia.html XX We are heartbroken over the loss of our friend Dolly Parton. Dolly was a beloved icon whose extraordinary generosity, warmth, and compassion touched countless lives, including those of the Children's Diabetes Foundation and the Barbara Davis Center for Diabetes. Her support of The Carousel Ball and Carousel of Hope Ball reflected her deep commitment to helping children and families affected by type 1 diabetes. Beyond her remarkable talent, Dolly will be remembered for the kindness and joy she shared so generously with others. Our hearts are with her family, friends, and all who loved her as we celebrate her extraordinary life and lasting legacy. She will be deeply missed.
Rural Health News is a weekly segment of Rural Health Today, a podcast by Hillsdale Hospital. News sources for this episode: Elizabeth Casolo, “Mount Sinai quietly stops accepting some new patients with government-backed plans,” August 19, 2026, https://www.beckershospitalreview.com/finance/mount-sinai-quietly-stops-accepting-some-new-patients-with-government-backed-plans/, Becker's Hospital Review. Elizabeth Casolo, “450,000 New Yorkers risk losing health coverage in wake of $7.5B federal funding cut,” September 10, 2025, https://www.beckerspayer.com/payer/450000-new-yorkers-risk-losing-health-coverage-in-wake-of-7-5b-federal-funding-cut/, Becker's Payer Issues. Sydney Halleman, “Hospitals feel the pinch as more patients lose insurance,” August 4, 2026, https://www.healthcaredive.com/news/hospitals-feeling-pinch-patients-lose-insurance/826764/, Healthcare Dive. Centers for Medicare and Medicaid Services, “CMS' program history,” https://www.cms.gov/about-cms/who-we-are/history. Nicole Huberfeld & Matthew Lawrence, “Why It Matters: HR1's Change to Medicaid Waiver Budget Neutrality Rules,” February 19, 2026, https://petrieflom.law.harvard.edu/2026/02/19/why-it-matters-hr1s-change-to-medicaid-waiver-budget-neutrality-rules/, The Petrie-Flom Center. Phil Galewitz, “Trump Team's Use of Arcane Budget Rule Threatens Medicaid Coverage,” August 14, 2026, https://kffhealthnews.org/medicaid/trump-cms-medicaid-expansion-1115-waivers-budget-neutrality-arkansas/, KFF Health News. The University of Arizona News, “U of A and Gila River Health Care (an entity of the Gila River Indian Community) launch nation's first MD-granting medical school branch within a Tribal Nation,” August 18, 2026, https://news.arizona.edu/news/u-and-gila-river-health-care-entity-gila-river-indian-community-launch-nations-first-md. Rural Health Today is a production of Hillsdale Hospital in Hillsdale, Michigan and a member of the Health Podcast Network. Our host is JJ Hodshire, our producer is Kyrsten Newlon, and our audio engineer is Kenji Ulmer. Special thanks to our special guests for sharing their expertise on the show, and also to the Hillsdale Hospital marketing team. If you want to submit a question for us to answer on the podcast or learn more about Rural Health Today, visit ruralhealthtoday.com.
12 - It's Friday! And are the Chinese in Chester County? Dom leads off with more AI data center talk. 1220 - Your calls. 1235 - Should bike lanes get priority over funeral processions? 1250 - The Friday Five! 1 - How ignorant was this CNN pundit covering RFK Jr.'s salmon cake recipe? 105 - Dear Mikie, Congressman Van Drew wrote you but you still ain't calling! Jeff Van Drew joins us today as today is the deadline for Mikie Sherrill to answer questions from a sitting Congressman regarding voters in and fraud in New Jersey. Did he get a response? What about the Lt. Governor? Where is the media coverage of this situation? What does Jeff think of the Paul Kanitra report on fraud and affordability? What is his take on putting AI data centers in the state? Any updates on his campaign? 120 - Would Harmeet Dillon even make it into a Philadelphia voting place? Your calls. 130 - Dr. Oz, Administrator of the US Centers for Medicare and Medicaid Services, is here this afternoon to highlight the giant slash to pharmaceuticals and medications that should help Americans everywhere. What kind of fraud cases has Oz been hearing about? What does he think about Dr. Fauci's testimony? What else does Dr. Oz want us to know? 150 - Your calls. 2 - New details come out of the possible Karmelo Anthony retrial. What's coming to Dom Time? 205 - Your calls. 215 - Dom's Money Melody! 230 - Members of East Whiteland United, Julie Ferris and Kelly Donia, join us this afternoon as their group fights back against the AI data center being constructed in their backyards. What is Kelly's motivation as a home and business owner in the area? Why is Julie concerned about her well water? What is the purpose of expanding the amount of supervisors on the East Whiteland township council? What do they say about those who say people like them are holding up the AI race between the US and China? Have there been any discussions on energy consumption? Where can we find them? 250 - The Lightning Round!
1 - How ignorant was this CNN pundit covering RFK Jr.'s salmon cake recipe? 105 - Dear Mikie, Congressman Van Drew wrote you but you still ain't calling! Jeff Van Drew joins us today as today is the deadline for Mikie Sherrill to answer questions from a sitting Congressman regarding voters in and fraud in New Jersey. Did he get a response? What about the Lt. Governor? Where is the media coverage of this situation? What does Jeff think of the Paul Kanitra report on fraud and affordability? What is his take on putting AI data centers in the state? Any updates on his campaign? 120 - Would Harmeet Dillon even make it into a Philadelphia voting place? Your calls. 130 - Dr. Oz, Administrator of the US Centers for Medicare and Medicaid Services, is here this afternoon to highlight the giant slash to pharmaceuticals and medications that should help Americans everywhere. What kind of fraud cases has Oz been hearing about? What does he think about Dr. Fauci's testimony? What else does Dr. Oz want us to know? 150 - Your calls.
Wisconsin Democrats chose Milwaukee County Executive David Crowley as their nominee for governor after a razor-thin primary upset against DSA candidate Francesca Hong. In Minnesota's Democratic Senate primary, Lieutenant Governor Peggy Flanagan defeats Congresswoman Angie Craig. Flanagan ran on a campaign to dismantle ICE, Medicare for all and a halt on sales of offensive weapons to Israel.Government funded sex changes for children have been halted. President Trump on Tuesday announcing the federal government will no longer use Medicaid funds to cover such procedures. The Centers for Medicare and Medicaid Services has also finalized a rule ending federal Medicaid and Children's Health Insurance Program funding for such procedures on children and young people.Kash Patel says homicides are down 17.2% across many of America's largest cities in the first half of 2026. He's crediting cooperation between the FBI, state and local law enforcement. Patel telling the Epoch Times the bureau is also targeting transnational criminal organizations that operate online scam compounds in Southeast Asia. Patel is urging Americans who believe they've been targeted by an online scam to contact the F-B-I as early as possible. He says every report can contribute to taking down a criminal network somewhere in the world.
Wisconsin Democrats chose Milwaukee County Executive David Crowley as their nominee for governor after a razor-thin primary upset against DSA candidate Francesca Hong. In Minnesota's Democratic Senate primary, Lieutenant Governor Peggy Flanagan defeats Congresswoman Angie Craig. Flanagan ran on a campaign to dismantle ICE, Medicare for all and a halt on sales of offensive weapons to Israel.Government funded sex changes for children have been halted. President Trump on Tuesday announcing the federal government will no longer use Medicaid funds to cover such procedures. The Centers for Medicare and Medicaid Services has also finalized a rule ending federal Medicaid and Children's Health Insurance Program funding for such procedures on children and young people.Kash Patel says homicides are down 17.2% across many of America's largest cities in the first half of 2026. He's crediting cooperation between the FBI, state and local law enforcement. Patel telling the Epoch Times the bureau is also targeting transnational criminal organizations that operate online scam compounds in Southeast Asia. Patel is urging Americans who believe they've been targeted by an online scam to contact the F-B-I as early as possible. He says every report can contribute to taking down a criminal network somewhere in the world.
Washington lawmakers approved nearly $20 million to help lawfully present noncitizens retain long-term care coverage, expecting to reach about 1,200 people. Federal rule changes from the Centers for Medicare and Medicaid Services mean only 173 will be covered. Around 1,500 noncitizens receiving long-term care services in Washington lose Medicaid on Oct. 1. https://www.clarkcountytoday.com/news/20m-in-long-term-care-money-for-wa-immigrants-to-cover-fewer-than-200-people/ #WashingtonState #Medicaid #LongTermCare #Immigrants #Healthcare #SEIU775 #FederalPolicy #WashingtonStateStandard
The Friday Five for August 7, 2026: ACA 2027 Certification Updates CY2027 ACA Premium Rate Filings So Far CMS 2027 Medicare Part D Bid Information 2027 Medicare Part B Cost Projections 2027 COLA Estimate Get Connected:
The Centers for Medicare and Medicaid Services finalizes Medicare hospital inpatient payment rates for fiscal year 2027. Two deaths in Michigan have been linked to the nationwide cyclospora outbreak. And a major pharmaceutical merger could be on the horizon. Listen to the latest episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.
Heard any of these myths about selling ACA plans? We're debunking the rumors and delivering facts on ACA insurance sales. Listen as we set the record straight here on the Agent Survival Guide Podcast! Read the text version Get Connected:
7.31.2026 #RolandMartinUnfiltered: Black Woman Jailed Over Land Battle. Trump Ends Medicare Help. Nolan Wells Autopsy Withheld. I'm here in Santee, South Carolina, for the 36th Jim Clyburn's Rudolph Canzater Memorial Classic, where the proceeds fund need-based scholarships for high school graduates and college students who live or attend school in South Carolina's 6th Congressional District.Here's what's coming up on Roland Martin Unfiltered, streaming live on the Black Star Network. Research of her family history landed her in federal custody. Jennine Labuzan (LAY-BOO-ZAN) is here to tell her story of how she spent two weeks in federal custody for refusing a judge's order to sign away more than 1,300 acres of land she says her family has owned for generations. The Trump Administration and the Centers for Medicare & Medicaid Services will end the Part D Premium Stabilization Demonstration. We'll talk to an expert about what that means for the nearly 25 million people who use Medicare. Mississippi has completed Nolan Wells' autopsy but has not publicly released it. We'll show you the bodycam video that has a Texas family of an unarmed black teen killed by police not buying the claim their 17-year-old committed suicide by cop. The Illinois Prisoner Review Board unanimously denied the medical release of the former sheriff's deputy serving 20 years for the second-degree murder of Sonya Massey in 2024. The Trump Administration is only trying to rewrite history; it is also redrawing the map of Africa, embarrassing the country during a global AIDS conference. We'll break down Politico's new poll, which reveals most of Trump's MAGA base say they'd still vote for a GOP candidate riddled with scandals. Black Star Network Partner: Chapter Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan’s contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don’t directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your options. ____ Download the Black Star Network app at http://www.blackstarnetwork.com! We're on iOS, AppleTV, Android, AndroidTV, Roku, FireTV, XBox and SamsungTV. The #BlackStarNetwork is a news reporting platform covered under Copyright Disclaimer Under Section 107 of the Copyright Act 1976, allowance is made for "fair use" for purposes such as criticism, comment, news reporting, teaching, scholarship, and research.See omnystudio.com/listener for privacy information.
Humana will reduce its Medicare Advantage footprint again in 2027. The Centers for Medicare & Medicaid Services will end a Medicare Part D premium stabilization program. And the American Red Cross has declared a national blood supply crisis. Listen to the latest episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.
The Friday Five for July 31, 2026: RegEd CE Courses Available on IntegrityCONNECT Fresh Take on Social Platforms: ThingsBook Medicare GLP-1 Bridge Reminder CMS Files Appeal to Clover Decision CMS & HHS File Expedited Appeal to Colombus I Get Connected:
Administrator of the U.S. Centers for Medicare and Medicaid Services, Dr. Mehmet Oz joins Bill to react to Dr. Anthony Fauci's refusal to answer questions before a Senate hearing, COVID missteps, vaccinations, and America's health concerns. Learn more about your ad choices. Visit megaphone.fm/adchoices
Referrals are a powerful lead generating tool, especially for insurance agents! Find out more in this explainer on referral marketing how to implement this strategy into your insurance business. Read the text version Get Connected:
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Drs. Michael Mack and Tom Nguyen about the proposed US Centers for Medicare & Medicaid Services changes to how cardiologists and cardiac surgeons interact during transcatheter aortic valve replacement (TAVR) procedures. Chapters 00:00 Intro 01:21 TAVR Heart Team 04:08 JANS 1+2, JACC TAVR vs SAVR 12:19 JANS 3, TAVR Short-Term Outcomes 14:06 JANS 4, SAVR Life Expectancy 17:44 JANS 5, WSJ TAVR Article 19:19 Video 1, Direct AA Cannulation Technique 21:23 Video 2, Endoscopic Redo TVR After CABG 24:25 Video 3, Gaudiani Cox-Maze III 27:33 Dr. Mack & Nguyen, TAVR Heart Team 51:12 Closing Dr. Mack explained the current heart team system, established in 2011 through collaboration with the US Food and Drug Administration (FDA) and CMS, which has been highly successful in ensuring safe and effective TAVR implementation. He argues that the proposed CMS changes could potentially dismantle this collaborative approach by allowing asynchronous patient evaluation and procedures to be performed by single operators without surgeon involvement. Dr. Nguyen provided insights from a system leader's perspective, noting that while the proposed changes raise significant concerns about patient care and data collection, some cardiologists argue that surgeons are already not actively involved in many programs, making the single operator model the norm in practice. Both expressed concern that without mandatory surgeon participation and TAVR registry involvement, smaller programs may adopt practices that lack proper accountability and could lead to inappropriate patient selection and outcomes, potentially creating more contentious debates between TAVR and surgical approaches. Joel also highlights recent JANS articles including a propensity-matched analysis comparing 10-year outcomes after SAPIEN 3 TAVR in the PARTNER 2 SAPIEN 3 Intermediate-risk Registry with surgery in the PARTNER 2A trial; a single-center retrospective study evaluated 61 patients who underwent cardiac surgery after prior TAVR during a 10-year period at a high-volume academic center; whether surgical aortic valve replacement (SAVR) should remain the first choice for aortic stenosis in patients with a life expectancy beyond five years; and an article examining the dramatic rise in the popularity of transcatheter aortic valves, early valve failure, and the impact it has on patients' lives. In addition, Joel explores axillary cannulation as a primary cannulation strategy, beating-heart endoscopic tricuspid valve replacement for high-risk redo patients after CABG and device-related tricuspid valve injury, and a Cox-Maze III operation combined with a left internal mammary artery (LIMA) to left anterior descending artery (LAD), as well as an ascending aortic replacement and aortic valve resuspension. Before closing, Joel highlights upcoming events in CT surgery. JANS Items Mentioned 10-Year Outcomes of SAPIEN 3 Transcatheter Aortic Valve Replacement or Surgery in Intermediate-Risk Patients A Decade of Cardiac Surgery After Transcatheter Aortic Valve Replacement: Short-Term Clinical Outcomes at a High-Volume Center Great Debate: Surgical Aortic Valve Replacement Is First Choice for Aortic Stenosis in Patients With a Life Expectancy Beyond 5 Years A Breakthrough Heart Procedure Comes With Risky Tradeoffs CTSNet Content Mentioned Direct Axillary Artery Cannulation With the Open Seldinger Technique Endoscopic Redo Tricuspid Valve Replacement After CABG The Cox-Maze III Procedure Combined With Valve-Sparing Aortic Surgery and CABG Other Items Mentioned Centers for Medicare & Medicaid Services Database—TAVR Career Center CTSNet Events Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.
Our recent blog post about a Medicare Part B vaccine billing update highlighted a clarification from Centers for Medicare & Medicaid Services. In this GAAP episode, our VP and health care cost report expert, Mark Lyons, provides a little more color to the situation and what it means for Rural Health Clinics and Federally Qualified Health Centers. Take 10 minutes to listen in to learn more!
President Donald Trump welcomed Lebanese President Joseph Aoun to the White House Tuesday to discuss ways to implement the Trilateral Framework, the U.S.-backed deal between Lebanon and Israel that was signed on June 26. Both leaders said they would address the deal's goals to expand Lebanese military control in the country's south, reduce Hezbollah's presence, and enable a phased Israeli withdrawal from Lebanese territory.Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. announced that the federal government will pause more than $1 billion in Medicaid payments to California and Minnesota over alleged fraud. Kennedy said HHS and the Centers for Medicare and Medicaid Services are using artificial intelligence and other tools to identify suspicious activity.New Jersey found around 6,600 non-citizens on its voter rolls due to a software error in the state's Motor Vehicle Commission system between June 2023 and June 2024. Gov. Mikie Sherrill said under 400 voted illegally and that she was “appalled” by the situation. The White House said in a press release that this error highlights the need to pass the SAVE America Act, which Republicans say will ensure election integrity.More Breaking News, Special Reports, and Live Coverage on NTD: https://ept.ms/NTD_LIVE
When your client has diabetes, what does (and doesn't) Medicare cover? We talk about how diabetes treatments, supplies, and services are covered by the different parts of Medicare so you can help your clients know what to expect. Read the text version Get Connected:
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
$100 billion. It's a huge number but that's the total amount the Trump Administration believes it can find in fraud across Medicaid and Medicare by 2029. The person helping lead that initiative is Stephanie Carlton, the deputy administrator of the Centers for Medicare and Medicaid Services. She's now directing efforts to make CMS an “AI […] The post Can AI Find Medicaid Fraud? That's the Mission of Stephanie Carlton, Dep. Admin, CMS appeared first on Healthy Communities Online.
12 - Do the Republicans finally have a leg to stand on by standing up to communism? Why does Dom love what Mike Johnson is saying? 1210 - Side - fictional character that deserves a statue 1215 - Who's more dangerous to Americans? Immigrants or Americans? 1230 - Administrator of the US Centers for Medicare and Medicaid Services, Dr. Mehmet Oz is back on the show. Did he think he'd be dealing with this much fraud in his position? Why are people upset at Medicaid qualifications when the bar is on the floor for coverage? Can Josh Shapiro stand up to this? What does Dr. Oz have to say about Lindsey Graham and how something like that can be prevented? 1250 - Do Democrats care about fraud? Your calls.
12 - Do the Republicans finally have a leg to stand on by standing up to communism? Why does Dom love what Mike Johnson is saying? 1210 - Side - fictional character that deserves a statue 1215 - Who's more dangerous to Americans? Immigrants or Americans? 1230 - Administrator of the US Centers for Medicare and Medicaid Services, Dr. Mehmet Oz is back on the show. Did he think he'd be dealing with this much fraud in his position? Why are people upset at Medicaid qualifications when the bar is on the floor for coverage? Can Josh Shapiro stand up to this? What does Dr. Oz have to say about Lindsey Graham and how something like that can be prevented? 1250 - Do Democrats care about fraud? Your calls. 1 - Did Patti LeBelle mess up the anthem last night? 110 - Sunny Hostin doubles down again and even equates the American flag to the Confederate one. 115 - How much should dry cleaning be? 120 - Has bowling become unaffordable? 130 - Who is Kathy Hochul blaming for business leaving New York? 140 - Your calls. 150 - Dom Giordano Presents: Progressive Women Gone Wild! Why are locals railing against the Bensalem School District? 155 - Are you calling Benny? 2 - What is the Philadelphia Public Schools problem? 210 - Your calls. 215 - Dom's Money Melody! 225 - Who will be AG? Todd Blanche? What do you think about the The Philly Parallel Parking Championship? 230 - How many miles of bike lanes are in the city? 235 - Your calls. 250 - The Lightning Round!
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning discusses the Centers for Medicare & Medicaid Services proposed decision memo regarding the national coverage analysis for transcatheter aortic valve replacement (TAVR). Chapters 00:00 Intro 01:17 TAVR National Coverage 06:05 JANS 1, EPOCH CardioLink-10 Trial 10:20 JANS 2, Dacron Ross Autograft Analysis 12:23 JANS 3, Mech vs Biopros Valve Outcomes 15:53 Video 1, Ross Procedure I/E Reduction 19:18 Video 2, Hemi-Commando Procedure 22:14 Video 3, Left VATS Enucleation Leiomyoma 24:15 Dr. Meguid, Intraop Molecular Imaging 35:52 Closing He outlines crucial deadlines, actionable steps for surgeons, the importance of submitting public comments, and the necessity of data collection. Additionally, he spoke with Dr. Robert Meguid, Professor of Surgery at the University of Colorado Anschutz Medical Campus, Aurora, CO, USA, about intraoperative molecular imaging. They explore how this technology identifies small nodules, the functionality and use cases of the specialized camera, the associated learning curve, and other available systems. The conversation also touches on robotics, lymph node staging, and cost. Furthermore, Dr. Meguid shares insights on his frequency of use of this technique. Joel also highlights recent JANS articles on a systematic review and meta-analysis on how complete Dacron reinforcement of Ross autograft does not increase neo-aortic valve regurgitation, a randomized trial on superficial parasternal intercostal plane block with ropivacaine vs placebo for opioid exposure after cardiac surgery, and outcomes after conversion from mechanical to bioprosthetic valves for anticoagulation-related complications. In addition, Joel explores the Ross procedure with internal and external reduction annuloplasty using autologous tissue rings, hemi-commando procedure for bioprosthetic aortic valve endocarditis, and left-sided uniportal VATS enucleation of a large esophageal leiomyoma. Before closing, Joel highlights upcoming events in CT surgery. JANS Items Mentioned Complete Dacron Reinforcement of Ross Autograft Does Not Increase Neo-Aortic Valve Regurgitation: A Systematic Review and Meta-Analysis Superficial Parasternal Intercostal Plane Block With Ropivacaine Versus Placebo for Opioid Exposure After Cardiac Surgery (EPOCH CardioLink-10): A Multicentre, Double-Blind, Randomised Trial Outcomes After Conversion From Mechanical to Bioprosthetic Valves for Anticoagulation-Related Complications CTSNet Content Mentioned Ross Procedure With Internal and External Reduction Annuloplasty Using Autologous Tissue Rings Hemi-Commando Procedure for Bioprosthetic Aortic Valve Endocarditis Left-Sided Uniportal VATS Enucleation of a Large Esophageal Leiomyoma Other Items Mentioned Centers for Medicare & Medicaid Services Database—TAVR Career Center CTSNet Events Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.
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:
Staying safe during extreme heat Dangerous, record-breaking heat has hit much of the nation this week, with the National Weather Service issuing an Extreme Heat Warning for the state of Ohio lasting until Thursday night. Many outdoor events have been canceled due to safety. The City of Cleveland canceled all youth outdoor sports through Friday, a Wade Oval Wednesday concert was canceled in University Circle, and the Cleveland Orchestra's free concert at Cain Park has been postponed, all due to dangerous conditions. This week, temperatures have hit the mid-to-high 90s, and Thursday the humidity will make the temperature feel as high as 107 degrees. To try to combat the heat, many cooling centers have opened around the region. We'll start Thursday's "Sound of Ideas" talking about how can to protect ourselves from heat-related injuries this week and throughout the summer. And, ahead of one of the most injury-prone holidays in the U.S., we'll ask our experts about staying safe this Fourth of July holiday. Guests: - Ellen Kazimer, Administrative Commander & Public Information Officer, Cleveland EMS - Tamanna Singh, M.D., Director, Sports Cardiology Center & Co-Founder & Co-Director, Women's Integrated Sports, Exercise, & Research Center, Cleveland Clinic & Volunteer, American Heart Association Medicare Pilot Program Ohio is one of six states testing out a Medicare pilot program that the federal government hopes will reduce fraud or waste in the system. The Centers for Medicare & Medicaid Services program WISeR, or Wasteful and Inappropriate Service Reduction, adds prior authorization for certain services that the government deems costly and unnecessary, and it operates using artificial intelligence. The government says the program will save money at the federal level and protect patients from unneeded care, but critics say its rollout since January has been rocky, leading to errors or delayed care, and reimbursement delays of up to 8 weeks to healthcare providers. An audience member inspired us to look more into this program on a show last week about aging well. Anita in Cleveland Heights called and said she was a senior on traditional Medicare and was shocked to discover after the fact that she needed pre-approval from her insurance to see certain doctors, and was facing a hefty bill that she would now need to appeal. Guests: - Gary Katz, M.D., President, Ohio State Medical Association - Darius Tahir, Correspondent, KFF Health News Ohio Revolutionary War graves As America approaches its 250th birthday, Americans are paying a bit more attention the country's founding, and the events surrounding 1776. Over the last year, more than 500 Ohioans volunteering their time took part in collecting data about those who actually served in the Revolutionary War. The Revolutionary War Graves Identification Project was an undertaking from the Ohio History Connection with the purpose of verifying and documenting the final resting places of those veterans buried in Ohio. Ideastream's Drew Maziasz spoke with Krista Horrocks from the Ohio History Connection about the graves project. The final public release of the grave survey will come out on July 4. Guest: - Krista Horrocks, Project Manager, Ohio History Connection
Rural Health News is a weekly segment of Rural Health Today, a podcast by Hillsdale Hospital. News sources for this episode: Forvis Mazars, “CMS Rule Signals Shift in Medicaid State-Directed Payments,” June 11, 2026, https://www.forvismazars.us/forsights/2026/06/cms-rule-signals-shift-in-medicaid-state-directed-payments. Medicaid.gov, “State Directed Payments,” https://www.medicaid.gov/medicaid/managed-care/guidance/state-directed-payments. Sturgis Hospital, “Sturgis Hospital Closure,” https://sturgishospital.com/sturgis-hospital-closure/. The Association of American Medical Colleges, “AAMC Statement on Proposed Rule on Medicaid Supplemental Payments,” May 21, 2026, https://www.aamc.org/news/press-releases/aamc-statement-proposed-rule-medicaid-supplemental-payments. U.S. Department of Health & Human Services, “Proposed Rule: Medicaid Managed Care State Directed Payments and Medicaid Fee-For-Service Targeted Medicaid Practitioner Payments (CMS-2449-P),” May 20, 2026, https://www.hhs.gov/guidance/document/proposed-rule-medicaid-managed-care-state-directed-payments-and-medicaid-fee-service. Michigan Health & Hospital Association, “CMS Releases FY 2027 Hospital Inpatient Prospective Payment System Proposed Rule,” April 17, 2026, https://www.mha.org/newsroom/cms-releases-fy-2027-hospital-inpatient-prospective-payment-system-proposed-rule/. Federal Register, “Medicaid Program; Medicaid Managed Care State Directed Payments and Medicaid Fee-for-Service Targeted Medicaid Practitioner Payments,” May 22, 2026, https://www.federalregister.gov/documents/2026/05/22/2026-10292/medicaid-program-medicaid-managed-care-state-directed-payments-and-medicaid-fee-for-service-targeted. Centers for Medicare & Medicaid Services, “Medicaid Managed Care State Directed Payments and Medicaid Fee-For-Service Targeted Medicaid Practitioner Payments Proposed Rule (CMS-2449-P,” May 20, 2026, https://www.cms.gov/newsroom/fact-sheets/medicaid-managed-care-state-directed-payments-medicaid-fee-service-targeted-medicaid-practitioner. Andrea Hooten, “New Rural Health Hub Connects Arkansans to Healthcare Resources, Opportunities,” June 15, 2026, https://news.uams.edu/2026/06/15/new-rural-health-hub-connects-arkansans-to-healthcare-resources-opportunities/, University of Arkansas for Medical Sciences News. Rural Health Today is a production of Hillsdale Hospital in Hillsdale, Michigan and a member of the Health Podcast Network. Our host is JJ Hodshire, our producer is Kyrsten Newlon, and our audio engineer is Kenji Ulmer. Special thanks to our special guests for sharing their expertise on the show, and also to the Hillsdale Hospital marketing team. If you want to submit a question for us to answer on the podcast or learn more about Rural Health Today, visit ruralhealthtoday.com.
The Friday Five for June 19, 2026: Certification for AEP 2027 Coming June 22 Microsoft Teams Location Tracking Medicare GLP-1 Bridge Starts July 1 CMS to Codify Medicare Drug Price Negotiation Federal Judge Vacates Several CMS ACA Provisions Get Connected:
The Friday Five for June 12, 2026: Apple WWDC 2026 Takeaways Instagram Grid Arrangement Feature IntegrityCONNECT Annuities & What's Coming Soon KFF MA Enrollment Stats & Trends for 2026 CMS Medicaid Work Requirements Get Connected:
In the first episode of this two-part 20-Minute Health Talk, Chethan Sathya, MD, sits down with Don Berwick, MD — former Center for Medicare and Medicaid Services administrator (CMS) and founder of the Institute for Healthcare Improvement (IHI). Dr. Berwick traces his path from early harrowing medical experiences to a career dedicated to improving patient care and healthcare delivery. The conversation moves to how patient solidarity could become a force for change and why simplifying to a single, public payer could create conditions that could fix the delivery of health care while actually improving patient choice and lowering costs. Northwell is New York State's largest healthcare provider and private employer, with 28 hospitals, 890 outpatient facilities and more than 16,600 affiliated physicians. We're making breakthroughs in medicine at the Feinstein Institutes for Medical Research. We're training the next generation of medical professionals at the visionary Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and the Hofstra Northwell School of Nursing and Physician Assistant Studies. Get the latest news and insights from our experts in the Northwell Newsroom: Press releases Insights Podcasts Publications Interested in a career at Northwell Health? Visit our career site and explore our many opportunities. Watch episodes of 20-Minute Health Talk on YouTube. For information on our more than 100 medical specialties, visit Northwell.edu and follow us @NorthwellHealth on Facebook, Instagram, X and LinkedIn.
1 - What is the craze about NYC? What will happen at the Knicks game tonight regarding Trump? 105 - Dom agrees with Madeleine Dean? Why do people support a literal Nazi? 110 - Why does this WNBA player oppose wearing “America 250” on her uniform? 130 - Dr. Mehmet Oz, the Administrator of the US Centers for Medicare and Medicaid Services, joins us today. Does he think Kensington is getting better after his visit last month? What's the biggest problem in a neighborhood like that? What is being done about Medicare and eBT fraud? What kind of people is Dr. Oz and his office going after? What does Dr. Oz think of Trump attending the NBA Finals tonight? Dr. Oz played in the Celebrity All-Star Game? 150 - Dom Giordano Program Presents: Progressive Women Gone Wild!
12 - Does Scott Pelley really believe there's no media bias? Is his service as a journalist on par with our soldiers that served? 1205 - Is Larry Krasner going after Cherelle Parker? Is something fishy going on with California's vote counting? 1215 - Side - song that is summer 1220 - Did Dom really get off at Trenton on his way back from Hempstead? What else did he encounter? 1240 - Bestselling author, Contributing Editor at National Review & Former Chief Asst. U.S. Attorney during “The Blind Sheikh” trial Andy McCarthy is here. With The Blind Sheikh's defense attorney running and likely winning a Congressional seat in New Jersey, what can Andy tell us about that case years ago? How are candidates like this propped up by craziness like we see on college campuses? 1250 - Your calls to round out the hour. 1 - What is the craze about NYC? What will happen at the Knicks game tonight regarding Trump? 105 - Dom agrees with Madeleine Dean? Why do people support a literal Nazi? 110 - Why does this WNBA player oppose wearing “America 250” on her uniform? 130 - Dr. Mehmet Oz, the Administrator of the US Centers for Medicare and Medicaid Services, joins us today. Does he think Kensington is getting better after his visit last month? What's the biggest problem in a neighborhood like that? What is being done about Medicare and eBT fraud? What kind of people is Dr. Oz and his office going after? What does Dr. Oz think of Trump attending the NBA Finals tonight? Dr. Oz played in the Celebrity All-Star Game? 150 - Dom Giordano Program Presents: Progressive Women Gone Wild! 2 - This substack on the Philadelphia Republican Party should be an eye opener for the establishment, but puts into context how much the party cannibalizes itself. 205 - Your calls. 210 - Dom's Money Melody! 220 - More of your calls. 235 - What are Guy Ciarrocchi's 10 Commandments of The Left? More calls. 250 - The Lightning Round!
The Friday Five for June 5, 2026: Certification Reminder Pod Rec: Before Breakfast TRICARE Resources for Agents Clover Health Star Ratings 2027 MA and Part D Max Commissions Get Connected:
Trump administration cabinet members and other federal and state officials denounced fraud in Medicaid and various government programs during a news conference in central Ohio. Acting U.S. Attorney General Todd Blanche was joined by FBI Director Kash Patel, Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services, and other officials. They announced the indictment of 14 people accused of schemes involving Medicaid providers, behavioral health services for people with autism and a romance fraud operation. More than 100 cameras at the Cuyahoga County Jail were found to be malfunctioning in January 2022. Officials were aware of the problem, but it took four years to replace them, according to reporting by The Marshall Project Cleveland. County officials said the project required more than $220,000 and that the funding did not become available until late last year. Properties used as short-term rentals through services such as Airbnb and Vrbo must now register with the city and comply with other new regulations approved by Cleveland City Council this week. The new wave band Devo performed at the Akron Civic Theatre on Wednesday. To commemorate the band's first show in Kent, state Rep. Michele Grim, D-Toledo, has introduced House Bill 866, which would designate April 18 as Devo Day in Ohio. These stories and more will be part of this week's discussion on the “Sound of Ideas Reporters Roundtable.” Guests:- Matt Richmond, Criminal Justice Reporter, Ideastream Public Media- Gabriel Kramer, Reporter/Producer, Ideastream Public Media- Karen Kasler, Bureau Chief, Ideastream Statehouse News Bureau
Dr. Mehmet Oz, the administrator of the Centers for Medicare and Medicaid Services, said on Tuesday that the Trump administration is increasing transparency on drug prices by adding 160 more medications to TrumpRx. He added that his agency is aggressively going after states for fraud in the Medicaid and Medicare programs.Acting Attorney General Todd Blanche says that the Trump administration is scrapping plans to create a $1.8 billion fund meant to compensate victims of government weaponization. Blanche says during a House hearing, "We are not moving forward with the fund, period."Secretary of State Marco Rubio testifies before the Senate Foreign Relations Committee about the State Department's budget request. He answers questions on the Trump administration's approach to Iran and Cuba.
Multiple Minnesota disability and addiction recovery services providers are scrambling to figure out what's next after they received notice on Monday they were removed from 14 high-risk Medicaid programs.The removal came from a state Department of Human Services process to revalidate 5,000 providers by May 31. DHS was required to do so through an agreement between the state and the federal government's Center for Medicaid Services, which was part of the Trump Administration's campaign to address fraud in Minnesota.Jordan Hansen, CEO of YourPath, an addiction recovery services provider and Cari McCann, executive director of Great River Homes, which provides care to individuals with disabilities, say their organizations were kicked off of the Medicaid programs. They joined MPR News host Nina Moini to talk about what comes next.Read more at MPRnews.org.
A must-listen episode: Host Dr. Jay Anders welcomes Kimberly Brandt, Chief Operating Officer and Deputy Administrator at the Centers for Medicare & Medicaid Services. Together they discuss slow value-based care adoption in Medicare, CMS's data quality push through FHIR APIs and USCDI, and how AI will help flag fraud across millions of daily claims. Brandt also discusses what it means for CMS to pay for 'outcomes rather than transactions'. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/
The 2027 Marketplace Final Rule from CMS is here! Join Sarah as she pulls out takeaways for insurance agents selling ACA plans. Get Connected:
From WEDI's Spring Conference, Amy Gleason (Centers for Medicare & Medicaid Services) and Ryan Howells (CARIN Alliance, Leavitt Partners) explore the vision behind the CMS Health Tech Ecosystem and its potential to transform how health data is accessed, exchanged, and used across the healthcare system. The discussion examines the value this approach could deliver for patients, providers, and innovators, while also highlighting how industry stakeholders can help build a more connected, interoperable, and consumer-centered digital health landscape.
Dr. Mehmet Oz, 17th Administrator of the Centers for Medicare & Medicaid Services, joins Sid live in-studio to discuss the scope of fraud in healthcare services, explaining how half of the fraud in the federal government could be originating from Medicaid and Medicare services. Learn more about your ad choices. Visit megaphone.fm/adchoices
Dr. Mehmet Oz, 17th Administrator of the Centers for Medicare & Medicaid Services, joins Sid live in-studio to discuss the scope of fraud in healthcare services, explaining how half of the fraud in the federal government could be originating from Medicaid and Medicare services. Learn more about your ad choices. Visit megaphone.fm/adchoices
The Friday Five for May 8, 2026: Quick Hits & Headlines CMS Admin Dr. Oz on Prior Auth Audio to Help You Sleep Cigna to Exit ACA for CY 2027 AHIP & NABIP Dates for CY 2027 Get Connected:
While Centers for Medicare & Medicaid Services does not explicitly define a strict “12-month rule,” its guidance does require that the physician’s involvement reflect ongoing, active participation in the patient’s course of treatment. That said, legal and compliance experts consistently caution that if a physician has not personally seen a patient within 12–24 months, billing subsequent non-physician practitioner (NPP) visits as “incident to” may present elevated audit risk. Terry breaks down the lack of clear regulatory thresholds and outlines practical steps to help protect your practice if an audit inquiry occurs. Subscribe and Listen Find all of Terry’s official links in one place: https://www.terryfletcher.net/links The post Incident to Physician Participation Rules appeared first on Terry Fletcher Consulting, Inc..
Host Radell Lewis sits down with Laura, candidate for Ohio's 7th Congressional District, to break down one of the most flippable Republican seats heading into 2026. Once a R+15 district, OH-7 is now R+5 after redistricting, and incumbent Max Miller squeaked by at 51 percent even in a friendlier map. With recent child abuse allegations surfacing against Miller and a brand new county (Ashland) full of farmers no one has bothered to talk to, this race has every ingredient for a flip. Laura brings 23 years of federal public service to the conversation, including work at the Centers for Medicare and Medicaid Services and the U.S. Department of Education Office for Civil Rights in Cleveland (an office that no longer exists thanks to this administration). Growing up between Cleveland and rural Athens County, she served patients, families, children, workers, veterans, and communities across seven federal agencies before being purged by DOGE last year. She has shown up in Northeast Ohio for years through boards, commissions, task forces, and community work. She is not running because politics is a career move. She is running because too many people in this district are being priced out, pushed aside, and told to expect less. In this conversation we cover: the unconstitutional war in Iran and why ending it lowers prices, Medicare for All as a today-not-tomorrow policy, the fifteen dollar minimum wage fight, why corporate capture of farmland and homes is the real threat, the Mamdani playbook for transparent representation, the loss of plausible deniability when this administration finds money for Argentina and Iran but not for working families, the dangers of party hypocrisy and the politics of exclusion, a humanist take on faith communities and the loneliness epidemic, and an honest assessment of Gaza, Israel, and the case for a two-state solution rooted in diplomacy rather than blank-check military aid. This is local politics done right: nuanced, honest, and built around results for actual constituents. Whether you lean left, right, or somewhere in the middle, this episode is for anyone who believes that the person we send to Congress should have the spine, the ethics, and the experience to challenge corruption on both sides of the aisle. Learn more about Laura's campaign at https://LauraforUs.com New episodes of Purple Political Breakdown drop weekly. Political solutions without political bias.Standard Resource Links & RecommendationsThe following organizations and platforms represent valuable resources for balanced political discourse and democratic participation: PODCAST NETWORKCheck Out the Podcast Website: www.purplepoliticalbreakdown.comALIVE Podcast Network - Check out the ALIVE Network where you can catch a lot of great podcasts like my own, led by amazing Black voices. Link: https://alivepodcastnetwork.com/ CONVERSATION PLATFORMSHeadOn - A platform for contentious yet productive conversations. It's a place for hosted and unguided conversations where you can grow a following and enhance your conversations with AI features. Link: https://app.headon.ai/Living Room Conversations - Building bridges through meaningful dialogue across political divides. Link: https://livingroomconversations.org/ UNITY MOVEMENTSUs United - A movement for unity that challenges Americans to step out of their bubbles and connect across differences. Take the Unity Pledge, join monthly "30 For US" conversation calls, wear purple (the color of unity), and participate in National Unity Day every second Saturday in December. Their programs include the Sheriff Unity Network and Unity Seats at sports events, proving that shared values are stronger than our differences. Link: https://www.us-united.org/ BALANCED NEWS & INFORMATIONOtherWeb - An AI-based platform that filters news without paywalls, clickbait, or junk, helping you access diverse, unbiased content. Link: https://otherweb.com/ VOTING REFORM & DEMOCRACYEqual Vote Coalition & STAR Voting - Advocating for voting methods that ensure every vote counts equally, eliminating wasted votes and strategic voting. Link: https://www.equal.vote/starFuture is Now Coalition (FiNC) - A grassroots movement working to restore democracy through transparency, accountability, and innovative technology while empowering citizens and transforming American political discourse. Link: https://futureis.org/ POLITICAL ENGAGEMENTIndependent Center - Resources for independent political thinking and civic engagement. Link: https://www.independentcenter.org/ GET DAILY NEWSText 844-406-INFO (844-406-4636) with code "purple" to receive quick, unbiased, factual news delivered to your phone every morning via Informed (https://informed.now)Check Out the Unfuck America Tour & National Ground Game: https://www.nationalgroundgame.com/Check Out the CIVICS App to Know More About Your Politicians: https://www.civicpolitics.com ALL LINKShttps://linktr.ee/purplepoliticalbreakdownThe Purple Political Breakdown is committed to fostering productive political dialogue that transcends partisan divides. We believe in the power of conversation, balanced information, and democratic participation to build a stronger society. Our mission: "Political solutions without political bias."Subscribe, rate, and share if you believe in purple politics - where we find common ground in the middle! Also if you want to be apart of the community and the conversation make sure to Join the Discord: https://discord.gg/ptPAsZtHC9
The Friday Five for May 1, 2026: [00:44] Staying Caffeinated on the Road [03:26] Healthcare or Health Care? AP Stylebook Makes it Official [05:24] Spotify Spins Fitness into the Mix [08:41] Medicare Advantage Improvement Act of 2026 [12:16] CMS Update on BALANCE Model & Medicare GLP-1 Bridge Events & Webinars for Insurance Agents Get Connected:
Health Affairs Publishing's Jeff Byers welcomes Senior Editor Michael Gerber back to the pod to discuss recent federal action on prior authorization, including CMS's proposal to expand response-time requirements to prescription drugs. The conversation also covers insurer efforts to reduce prior auth volume, the promise of AI and prior authorization, and what increased transparency could reveal about costs.To learn more, check out our recent Insider trend report on the current prior authorization landscape. And if you haven't already, join Insider today to get access to exclusive events, newsletters, cheat sheets, and reports.Related Links:CMS proposes new deadlines for prior authorizations for drugs (Healthcare Dive)2026 CMS Interoperability Standards and Prior Authorization for Drugs Proposed Rule (CMS)A Rule by the Centers for Medicare & Medicaid Services on 02/08/2024 (Federal Register)Health Plans Reduce Prior Authorization, Support Continuity of Care and Enhanced Consumer Communications (Blue Cross Blue Shield)AI speeds up prior auth, coding while driving higher costs for health systems: PHTI report (Fierce Healthcare)Sign up for our free Health Affairs newsletters to stay up to date on health policy news and analysis.
The Friday Five for April 17, 2026: [00:57] CMS 2027 MA and Part D Final Rule [02:09] Google Announces New Chrome Features [04:56] March 2026 CPI/2026 FOMC Calendar [07:03] Protective Life Corporation Study on Gaps in Medicare Knowledge [10:17] CMS 2026 Prior Authorization Proposed Rule Get Connected:
A rural Minnesota hospital system could be forced to close within weeks as millions of dollars in Medicare payments have been delayed. The Mille Lacs Health System is at risk of closing its hospital and rural health clinics that serve multiple counties. That's because the Centers for Medicare and Medicaid Services has withheld about $2.5 million dollars in Medicare payments since January.A new lawsuit is challenging the Trump Administration's move to fast-track deportations of Somalis. The Advocates for Human Rights — a Minneapolis nonprofit — is suing the Justice Department over its effort to speed up deportations of non-citizens from Somalia. The government had already targeted many for removal, but the plaintiffs allege that the administration is fast-tracking court hearings for Somalis after President Donald Trump called them "garbage."
Dr. John Whyte has spent his career at the intersection of medicine, media and public policy. Now, as CEO of the American Medical Association, he hears firsthand what physicians, patients and health leaders are most concerned about and what they expect from the future of healthcare. That perspective makes him an ideal guest for Season 11 of Fixing Healthcare with cohosts Dr. Robert Pearl and Jeremy Corr. This season's guests bring more than impressive résumés and large social-media followings. They bring insight into what people across the country are actually talking about: the fears they express, the questions they ask and the expectations they carry into exam rooms, boardrooms and online conversations. Whyte has held leadership roles at the FDA and Centers for Medicare & Medicaid Services. He later became chief medical officer at WebMD and chief medical expert for Discovery Channel. In each position, he has focused on translating complex medical issues into clear, actionable information. In this conversation, he shares what he is hearing now and why the answers will require both cultural and structural change. Key highlights include: Three concerns dominate for physicians. Whyte opens by identifying what he hears most often across the country: frustration with prior authorization and payment incentives in Medicare and Medicaid, anxiety about scope-of-practice changes, and uncertainty about how physicians should lead (rather than react to) the rapid rise of digital health and generative AI. Medicaid disruption and impact on children. Whyte explains that policy changes at both federal and state levels could leave vulnerable populations without coverage or access to care. He emphasizes that nearly half of U.S. children rely on Medicaid. Payment models and physician autonomy. The discussion explores tensions between fee-for-service, Medicare Advantage and value-based approaches. Whyte argues that physicians must retain meaningful choice in how they practice and get paid, even as consolidation and employment models reduce autonomy. Generative AI as “augmented intelligence.” Whyte notes that more than 80% of physicians now use AI tools professionally, largely for documentation and communication tasks. The real opportunity, he says, lies in improving diagnosis, personalization and continuous monitoring. Home as the future site of care. From wearables to smart diagnostic devices, Whyte envisions a shift away from episodic office visits toward continuous monitoring and preventive care. Outcome-based reimbursement. Pearl asks whether paying for outcomes could unlock broader adoption of AI-enabled tools. Whyte acknowledges the promise but highlights practical challenges, including patient complexity, burnout and the risk that efficiency gains could simply lead to higher patient volumes. The evolving physician-patient relationship in the AI era. With a growing share of patients using generative AI before appointments, Whyte encourages clinicians to view digitally informed patients as partners. Open dialogue, trusted sources and shared decision-making, he argues, will define effective care in the years ahead. There's so much more to this episode. Tune in to find out what physicians and patients should expect from the future of medicine. * * * Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn The post FHC #209: What the AMA’s new CEO is hearing from doctors & patients right now appeared first on Fixing Healthcare.
Medicare and Medicaid fraud. California healthcare corruption. Constitutional crisis. California is now being called the epicenter of Medicare and Medicaid fraud, with billions of taxpayer dollars allegedly lost to fake patients, phantom billing, and sham hospice operations. In this full podcast episode, Dr. Mehmet Oz, Administrator of the Centers for Medicare & Medicaid Services explains why Los Angeles has become ground zero for healthcare fraud and how these schemes drain public healthcare programs meant to serve real patients. Dr. Oz alleges that organized fraud networks are exploiting Medicare and Medicaid at massive scale. Gavin Newsom denies the claims, accusing Oz of exaggeration and discrimination — escalating the conflict into a political and legal firestorm. This episode then turns to a second crisis: federal law vs state and city governments. Across blue cities, police departments are ordered to monitor and film ICE agents, federal officers are barred from city property, and taxpayer funds are used to oppose federal immigration enforcement. Is this lawful protest — or obstruction of federal authority? Constitutional attorney Josh Hammer breaks down: • The Supremacy Clause of the U.S. Constitution • When state resistance becomes unconstitutional • The legal implications of **Don Lemon arrest • What legal remedies exist to restore order without destabilizing the country This episode covers Medicare fraud, Medicaid abuse, California corruption, federal vs state power, ICE enforcement, constitutional law, and government overreach — with facts, legal analysis, and real consequences. Learn more about your ad choices. Visit megaphone.fm/adchoices
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