Simon Barr

CMS Releases New Oversight Rules for Medicaid State-Directed Payments

September 11, 2025

CMS has released new guidance tightening federal oversight of Medicaid state-directed payments (SDPs) in managed care. The update centers on transparency, documentation, and measurable quality outcomes—signaling stronger guardrails on financing, distribution methodologies, and alignment with actuarial soundness and value-based care. Payers, providers, and state agencies should prepare for enhanced monitoring and reporting expectations.

Understanding Pediatric Cancer: Improving Detection and Family Support

September 11, 2025

Explore innovations in early detection, treatment advancements, and holistic care strategies in pediatric cancer. Support Childhood Cancer Awareness Month by learning how to improve outcomes for young patients and their families.

World Mental Health Day: Action Guide for Healthcare Leaders

September 10, 2025

Turnkey guide for World Mental Health Day 2025—leadership actions, toolkits, and talking points to boost mental-health impact across your organization.

Breast Cancer Awareness Month: Resources and Information

September 9, 2025

Prepare for October Breast Cancer Awareness Month with evidence-based facts, actionable steps, and official ACS and CDC resources for early detection.

Key Disclosure Requirements Under CMS Healthcare Price Transparency Rules

September 9, 2025

Explore the CMS disclosure requirements driving payer risk and compliance exposure. And how to align governance, vendors, and validation before penalties hit.

Suicide Prevention in Healthcare Settings: Identifying and Intervening Early

September 4, 2025

Discover evidence-based screening protocols and intervention strategies for suicide prevention in healthcare settings. Learn how to identify at-risk patients early and connect them to crucial behavioral health support.

Real-Time Drug Price Transparency Coming for U.S. Consumers

September 3, 2025

HHS has finalized a rule (HTI-4) to deliver real-time prescription drug price transparency at the point of care, giving clinicians and consumers visibility into patient-specific coverage, out-of-pocket costs, and prior authorization requirements through certified health IT. The move aims to reduce administrative burden, speed access to therapy, and support more cost-effective prescribing aligned with value-based care goals.

Flu Vaccine Planning: Preparing for Fall Immunization Campaigns

August 28, 2025

Prepare for the fall flu season by planning early vaccination campaigns. This guide offers strategies for focusing on high-risk populations.

Gold Card Explained: Reducing PA Burden Through Smart Provider Incentives

August 26, 2025

Explore how gold carding reduces the burden of prior authorization for healthcare providers by rewarding consistent, guideline-adherent care.

HHS Seeks Nominations for New Healthcare Advisory

August 21, 2025

HHS and CMS are creating the Healthcare Advisory Committee, a group of experts tasked with providing strategic recommendations directly to HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz.
The goal: improve how care is financed and delivered across Medicare, Medicaid, CHIP, and the Health Insurance Marketplace, while reducing red tape and putting patients first.

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