BHM Healthcare Solutions

05/15/2026

There’s a lot of movement right now around 𝗖𝗠𝗦-𝟬𝟬𝟱𝟳-𝗙, 𝗖𝗠𝗦-𝟬𝟬𝟲𝟮-𝗣, and evolving ePA expectations. If it feels like everything in prior auth and interoperability is shifting at once, you are not wrong.

BHM is putting together a panel discussion to dig into what is happening behind the scenes as these rules roll out.

Stay tuned for webinar details, or send us a message if you would like a personal invitation once the session is scheduled.

05/14/2026

For government programs, every claim and appeal needs to be clear, accurate, and easy to stand behind. Independent review brings structure that supports fair and consistent medical necessity decisions.

𝘞𝘩𝘢𝘵 𝘱𝘢𝘳𝘵 𝘰𝘧 𝘺𝘰𝘶𝘳 𝘱𝘳𝘰𝘤𝘦𝘴𝘴 𝘨𝘪𝘷𝘦𝘴 𝘺𝘰𝘶 𝘵𝘩𝘦 𝘮𝘰𝘴𝘵 𝘳𝘦𝘢𝘴𝘴𝘶𝘳𝘢𝘯𝘤𝘦 𝘸𝘩𝘦𝘯 𝘢 𝘤𝘢𝘴𝘦 𝘪𝘴 𝘤𝘩𝘢𝘭𝘭𝘦𝘯𝘨𝘦𝘥?

05/13/2026

A recent CMS press release is announcing a nationwide moratorium on new Medicare enrollments for hospice providers and home health agencies (HHAs) as part of a broader Medicare program integrity and fraud prevention initiative targeting high-risk post-acute care service categories.

CMS announced a nationwide six-month enrollment moratorium for hospice and home health agencies, signaling expanded utilization oversight, fraud prevention efforts, increased scrutiny of prior authorization, claims review, & post-acute care management practices across the payer industry.

05/12/2026

Lasting results rarely come from a single big change, they grow out of clearer workflows, cleaner data, and stronger standards that are followed every day. Step by step, the whole process becomes easier to trust.

𝘐𝘯 𝘺𝘰𝘶𝘳 𝘸𝘰𝘳𝘭𝘥, 𝘸𝘩𝘢𝘵 𝘪𝘴 𝘰𝘯𝘦 𝘴𝘮𝘢𝘭𝘭 𝘰𝘱𝘦𝘳𝘢𝘵𝘪𝘰𝘯𝘢𝘭 𝘤𝘩𝘢𝘯𝘨𝘦 𝘵𝘩𝘢𝘵 𝘮𝘢𝘥𝘦 𝘢 𝘣𝘪𝘨 𝘥𝘪𝘧𝘧𝘦𝘳𝘦𝘯𝘤𝘦 𝘰𝘷𝘦𝘳 𝘵𝘪𝘮𝘦?

05/11/2026

𝗠𝗮𝘆 𝟭𝟬𝘁𝗵-𝟭𝟲𝘁𝗵 is , a time to recognize the hospitals, health systems, and health care workers who bring hope and healing to their communities every day.

Whether you are caring for patients at the bedside, managing complex operations, or supporting from behind the scenes, your work matters. 𝘛𝘩𝘢𝘯𝘬 𝘺𝘰𝘶 𝘧𝘰𝘳 𝘢𝘭𝘭 𝘺𝘰𝘶 𝘥𝘰.

05/08/2026

Rather than introducing a new policy initiative, a May 5, 2026 CMS blog post authored by Administrator Dr. Mehmet Oz reinforces that implementation timelines tied to CMS interoperability and prior authorization reforms are already underway and now require broader coordination among payers, providers, hospitals, physician practices, EHR vendors, pharmacy stakeholders, and digital health developers.

CMS reinforced ongoing electronic prior authorization implementation efforts across the healthcare industry, highlighting interoperability coordination, payer workflow modernization, and key operational deadlines extending through 2027.

05/08/2026

During , our thoughts are with the nurses who show up for patients and families in so many different ways.

To nurses everywhere: thank you for the care you provide, the reassurance you offer, and the countless moments of kindness that rarely get seen. You matter more than you know.

05/07/2026

Operational excellence is not loud. You see it in the way work gets done the same careful way every time. Strong utilization management is not only about the final determination. It starts with a process that is clear, consistent, and objective so decisions are easier to defend and easier to trust.

𝘏𝘰𝘸 𝘤𝘰𝘯𝘧𝘪𝘥𝘦𝘯𝘵 𝘢𝘳𝘦 𝘺𝘰𝘶 𝘪𝘯 𝘵𝘩𝘦 𝘱𝘳𝘰𝘤𝘦𝘴𝘴 𝘣𝘦𝘩𝘪𝘯𝘥 𝘺𝘰𝘶𝘳 𝘥𝘦𝘵𝘦𝘳𝘮𝘪𝘯𝘢𝘵𝘪𝘰𝘯𝘴 𝘵𝘰𝘥𝘢𝘺?

05/06/2026

can feel big and abstract, so we kept this one simple.

Swipe through for a few affirmations you can use on the days that feel heavier. Save the ones that resonate and pass them along to someone who might need them too.

These are inspired by Mental Health America’s “More Good Days, Together” resources.
👉 https://mhanational.org/mental-health-month/

05/05/2026

Leadership changes happen. The real question is: 𝘸𝘩𝘢𝘵 𝘩𝘢𝘱𝘱𝘦𝘯𝘴 𝘵𝘰 𝘺𝘰𝘶𝘳 𝘳𝘦𝘷𝘪𝘦𝘸 𝘱𝘳𝘰𝘤𝘦𝘴𝘴 𝘸𝘩𝘦𝘯 𝘵𝘩𝘦𝘺 𝘥𝘰?

Without a steady clinical lead, reviews slow down, expectations get fuzzy, and teams start to feel the strain. A transitional Medical Director can keep things steady so staff, providers, and members don’t feel the ripple effects of a leadership shift.

05/04/2026

It is from 𝗠𝗮𝘆 𝟯 𝘁𝗼 𝟵, and this year’s theme is “ : Education, Prevention, Connection.”

The National Federation of Families is taking a closer look at how technology, family life, and school all affect the mental health of children and teens, and how we can protect the real-life connections that help them feel supported.

If you are a parent, caregiver, or someone who works with youth, you can explore ideas and resources for this week here:
👉 https://www.ffcmh.org/actionweek

📅 To stay ahead of upcoming health observances, explore BHM’s Healthcare Awareness Planning Guide and monthly observance article: https://bhmpc.com/health-awareness-observances-list-monthly-planning-tool/