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Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
Building the Evidence File for PCMH Annual Reporting Under Standards 11.1
PCMH annual reporting is a documentation exercise, and the practices that struggle are the ones that start collecting evidence a month before the due date. Here is how we build the evidence file across the year under NCQA Standards Version 11.1, what changed in 2026, and the reports that satisfy reviewers.
MIPS 2027 Under the CY 2027 Proposal: New MVPs, Core Measures and a 2029 Sunset
Comments on the CY 2027 fee schedule proposal closed September 14, and the Quality Payment Program section is the part practices have read least. Here is what CMS proposed for MIPS 2027: three new MVPs, core measures, a changed Promoting Interoperability list and the end of traditional MIPS after 2028.
MIPS 2026 Year-End Checkpoints: What Must Be True by December 31
The 2026 MIPS performance year ends December 31, the threshold is 75 points and the penalty for missing it is up to 9 percent of 2028 Part B payments. Here is the September checkpoint list: performance periods that must already be running, data completeness, the security risk analysis and the submission window.
Closing Gaps in Care Before Year-End: Start the Outreach Push in September
Every quality program that pays your practice measures on a calendar year ending December 31, and this year patients are more likely than usual to change plans or lose coverage in January. Practices that run gap outreach from September through early December close more gaps. Here is the plan, step by step.
PCMH Annual Reporting in a Year of Coverage Churn: Keeping Panels Honest
Recognized practices report to NCQA every year, and 2026 is a year when panels are about to move: Medicaid six-month renewals and work requirements arrive in December and Marketplace premiums are rising for 2027. Here is how to keep empanelment, quality data and care management accurate through the churn.
MIPS 2027 Proposed Changes: Core Measures, MVPs and the End of Traditional MIPS
The CY 2027 Physician Fee Schedule proposed rule carries the biggest Quality Payment Program changes in years: a required MIPS core measure, three new MVPs, a plan to sunset traditional MIPS after 2028 and a new electronic prior authorization measure. Comments close September 14, 2026. What small practices should read.
Interpreter Services in a Medical Practice: Legal Duties, T1013 and Who Pays
Practices must provide qualified interpreters to patients who need them, usually at their own expense. We lay out what Title VI, Section 1557 and the ADA require, who may and may not interpret, which Medicaid programs pay HCPCS T1013, the tax credit that offsets sign language costs, and a workflow that holds up.
How to Prepare a Practice for PCMH Recognition: The Order of Work That Holds Up
Recognition follows workflows, not binders. A practical order of work for practices starting toward the medical home: a champion with protected time, an honest assessment, access and coordination workflows first, EMR reports confirmed early, an evidence library built as you go, and a plan for annual reporting.
Talking to Patients About 2027 Coverage Changes: Scripts, Letters and Timing
Marketplace insurers want a 15 percent median premium increase for 2027, Medicaid expansion adults face six-month renewals and work requirements, and deductibles reset in January. Patients will ask your staff what to do. Here is what to say, when to say it, and the four letters to have ready.
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