Suzanne York

An online article posted on Axios Vitals highlights the problems patients and providers face with obtaining prior authorizations from Medicare Advantage plans. The article cites a KFF finding that there were 53 million prior authorization requests made to Medicare Advantage plans in 2024, of which 8% were fully or partially denied. As stated by Representative […]

CMS awarded grants to all fifty states under the Rural Health Transformation Program. Now states have until January 30, 2026 to resubmit budgets showing how they intend to use their grant money to implement their proposed projects and CMS has 30 days to respond. These next steps will be critical in showing whether rural hospitals

The Centers for Medicare & Medicaid Services has awarded grants to all fifty states under the Rural Health Transformation Program. The average grant for 2026 is $200,000, with grants ranging from $147 million to $281 million. The states receiving the highest amount of grants were Texas at $218 million, Alaska at $272 million, and California

Becker’s Hospital Review has published an article detailing the myriad policy changes to be implemented in 2026 that will impact hospitals and other medical providers. Among the most significant policy changes are: The expiration of the enhanced subsidies under the Affordable Care Act that allowed households earning more than 400% of the federal poverty level

The New York State Department of Health has issued new rules governing the temporary or permanent closures of healthcare facilities. The new rules updated and clarified previous rules governing facility closures. Under the new rules, healthcare facilities may not close, discontinue services or reduce beds without prior approval of the facility’s Closure Plan. Temporary closures

The Settlement Claims Administrator for the BCBS Provider Antitrust Settlement has updated the claims website with the following information: “The claim submission deadline for the Blue Cross Blue Shield Provider Settlement passed on July 29, 2025.  The Settlement Administrator is no longer accepting new claims or changes to existing claims absent a showing of good

The Alabama Hospital Investment Program provides a dollar-for-dollar tax credit against state income and other taxes for individuals and businesses that donate to eligible rural hospitals in Alabama. The Program was established by statute and is available for the tax years from 2026 – 2028. It is intended to help eligible rural hospitals receive additional

On September 23, 2025, Judge R. David Proctor entered an order establishing the Monitoring Committee for the Blue Cross Blue Shield Provider Settlement.  The Committee will be comprised of:  Whatley Kallas partner, W. Tucker Brown, and Healthcare Association of New York State (formerly “Hospital Association of New York State”) Special Counsel for Managed Care and

In a strongly worded letter to the Health Resources and Services Administration (“HRSA”), the American Hospital Association has asked HRSA to abandon the proposed 340B Rebate Model Pilot Program (“the Pilot Program”), or to delay its implementation until issues with the costs of compliance with it could be fixed. The 340B Drug Pricing Program allows

Whatley Kallas is pleased to announce that the $2.8 Billion Blue Cross Blue Shield Antitrust Settlement, the largest payment in a healthcare antitrust case, has become effective. The Settlement also contains injunctive relief that plaintiffs’ experts value in excess of $17.3 billion. There were no appeals from the Court’s final approval of the Settlement. Whatley