Revenue & Reimbursement

Healthcare reimbursement is payment that a hospital, diagnostic imaging facility, subspecialty department or healthcare providers receive for performing a service. This also includes individual radiologist or cardiologist reimbursement and billing and coding rules for submitting claims.

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SCAI outlines broken Medicaid reimbursement model for congenital heart disease

SCAI says many children and adults living with congenital heart disease are being left behind by a payment system that does not adequately value their care.

Anders Gilberg, MGA, Senior Vice President, Government Affairs at Medical Group Management Association (MGMA), said the rapid fire changes in healthcare policy under the Trump administration has been a whirlwind with a mix of reactions by stakeholders to policies based on reality and and also perception of possible impacts. #MGMA

MGMA weighs in on Washington’s political turmoil, Medicaid cuts and healthcare policy uncertainty

“It’s been a whirlwind,” Anders Gilberg, senior vice president of government affairs at MGMA, told HealthExec. “Rarely do we have an administration come in and do so much in such a short period of time.”

MGMA's Anders Gilberg says Congress needs to act soon to preserve access to telemedicine programs.

MGMA: Congress needs to act soon to preserve access to telemedicine programs

Congress needs to act soon to extend telemedicine services that were greatly expanded under COVID provisions, or they will expire by October. Anders Gilberg, senior vice president of government affairs at the Medical Group Management Association, explains concerns raised by doctors and lawmakers.

 

American Society of Nuclear Cardiology (ASNC) President-elect Jamieson M. Bourque, MD, MHS, FASNC, medical director of nuclear cardiology, echocardiography, and the stress laboratory at UVA Health in Charlottesville, and a professor of medicine and radiology at the University of Virginia, said the society is fighting a major proposed cut in CMS reimbursements in 2026.

ASNC calls on members to fight 57% Medicare cut for cardiac amyloid imaging

Jamieson M. Bourque, MD, MHS, president-elect of the American Society of Nuclear Cardiology, shared the group's concerns with Cardiovascular Business. “This is going to have a highly negative impact," he said. 

Anders Gilberg, MGA, senior vice president, government affairs at Medical Group Management Association (MGMA) explained the need to renew the Medicare geographic pay adjustments in rural areas to make payments more competitive than urban areas. He said this is vital to help retain physicians in rural areas who otherwise could find higher paying jobs in larger cities.

Looming end of Medicare rural pay adjustment raises concerns about doctor shortages

Anders Gilberg, senior vice president of government affairs at the Medical Group Management Association, explains why Congress needs to renew the Medicare geographic pay adjustments in rural areas—to make payments competitive with urban areas and help retain physicians in those communities.

nders Gilberg, MGA, senior vice president, government affairs at Medical Group Management Association (MGMA), shares concerns about the draft fee schedule published in July. Congress was poised to reverse part of the cut in physician pay last December, but Elon Musk intervened and no fix was made. Congress instead made promises to help in 2026, but MGMA says it is not enough.

MGMA raises alarm over 2026 Medicare Physician Fee Schedule, warns of access crisis

Many make federal reimbursement plans into an issue about high-paid specialists complaining about pay cuts, but these fees also compensate nurses, technicians, support staff and administrators. Payment keeps the doors of brick-and-mortar medical practices open, MGMA warns.

Anders Gilberg, MGA, senior vice president, government affairs at Medical Group Management Association (MGMA), shares concerns about the draft fee schedule published in July. A major concern is the government possibly changing how relative value units (RVUs) are set, rather than allowing the American Medical Association and medical speciality representatives having a say. #MGMA

MGMA warns of government overreach in the proposed 2026 Medicare Physician Fee Schedule

The Medical Group Management Association shares concerns about the draft fee schedule published in July. A major concern is the government possibly changing how RVUs are set, rather than allowing the medical specialty representatives to have a say.

Boston Scientific’s Agent Drug-Coated Balloon (DCB), which delivers a therapeutic dose of the anti-proliferative drug paclitaxel to the patient’s scar tissue to prevent ISR from recurring, gained FDA approval on March 1..

Boston Scientific’s coronary DCB gains new Medicare reimbursement

The first coronary DCB to gain FDA approval just received an additional reimbursement that could improve patient access. 

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