Category: Policy Updates
HealthFirst 2026 Payment Integrity Alert
Facility vs. Non-Facility Misclassification Driving Systemic Underpayments By Susanna Bekirova, Billing Department, WCH
The Medicare Fraud Strike Force in 2026: Why Every Healthcare Provider Is Now Practicing Under a Federal Data Radar
By Nana Kazhiloti, Credentialing Department, WCH Building on our recent analysis of rising CMS claim denials, it is becoming clear…
CMS-0057-F: The Federal Rule That Could Finally Break the Prior Authorization Bottleneck
For years, prior authorization has functioned as one of the most expensive invisible taxes in American healthcare. Physicians order medically…
The Algorithm That Underpays You: What the MultiPlan and Zelis Lawsuits Mean for Independent Providers
And why your billing partner’s expertise has never mattered more. By Elena Pak, Credentialing Department, WCH The $19 Billion Problem…
The Ground Is Shifting: What Healthcare Providers Must Act On Now
By Oksana Pokoyeva, Billing Department, WCH The week of April 14, 2026 delivered a concentrated dose of signals that, taken…
The Courthouse Door Is Closed: What the Aetna–Radiology Partners Ruling Means for Providers and Payers
By Elena Pak, Credentialing Department, WCH A federal judge’s dismissal of Aetna’s fraud lawsuit against Radiology Partners last week is…
When Contracts Collapse: What the Catholic Health–Healthfirst Split Signals for Providers
By Elena Pak, Credentialing Department, WCH A looming network split between Catholic Health and Healthfirst in New York is more…
UnitedHealth Group Under Pressure: AI Expansion, Regulatory Scrutiny, and Contracting Volatility Signal a New Payer Era
UnitedHealth Group’s recent headlines form a coherent narrative rather than a collection of unrelated developments. Across Medicaid contracting shifts, AI…
Fraud Behind Mental Health Provider Directories
By Elena Pak, Credentialing Department, WCH A federal judge in New York has allowed a major class action lawsuit against…