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The U.S. health insurance system is undergoing rapid transformation, driven by evolving regulations and a pressing need to balance consumer protections with rising costs. These shifts are forcing healthcare payers to adapt quickly, impacting everything from how they reimburse providers to the technologies they employ to maintain operational efficiency.
Staying ahead of these changes is no longer optional; it’s a critical imperative for financial stability and maintaining trust with both healthcare providers and patients. As one analyst noted, “Understanding the payment integrity implications of upcoming rules is essential to avoid costly missteps and ensure continued alignment with industry standards.”
Webinar to Tackle Key 2026 Challenges
To help industry stakeholders navigate this complex environment, Cotiviti is hosting a webinar on Thursday, December 18, at 1 pm ET, the final installment of their 2025 Payment Integrity Pulse series. The session will focus on the most pressing changes expected to impact the healthcare payment landscape in 2026. Participants can register for the webinar to receive the on-demand recording if they are unable to attend live.
Telehealth Billing Under Scrutiny
A key area of focus will be the proposed changes to the 2026 Physician Fee Schedule, particularly as they relate to telehealth. According to a company release, the webinar will explore how updates from the Centers for Medicare & Medicaid Services (CMS) could reshape virtual care billing practices and necessitate adjustments to payer strategies. This is particularly important given the continued growth of telehealth and the need for clear, consistent reimbursement policies. “
Reimbursement Changes for Skin Substitutes and DMEPOS
The webinar will also delve into proposed CMS changes regarding skin substitute reimbursement and accreditation requirements for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS). These proposals carry significant financial and compliance implications, including potential changes to prior authorization processes, stricter accreditation standards, and increased monitoring of claims.
Emerging Fraud, Waste, and Abuse Threats
Beyond regulatory changes, the session will address emerging trends in fraud, waste, and abuse (FWA). Experts will share insights into potential FWA patterns that may arise in 2026 as a result of the new rule changes. Proactive identification and mitigation of these risks will be crucial for payers seeking to protect their bottom line and ensure responsible stewardship of healthcare resources.
Don’t miss this opportunity to stay informed as the healthcare industry heads into 2026. Registration for the webinar is open, and those unable to attend live will receive access to the on-demand recording.
