CMS Issues Update on Holding of Claims for Affected Services. The Centers for Medicare & Medicaid Services (CMS) provided an update on the processing of claims and payments for services affected by the expired Medicare legislative provisions as of October 1. CMS has instructed Medicare Administrative Contractors to hold these claims but will continue to process and pay held claims in a timely manner, except for claims for services impacted by expired provisions. As of October 16, payments have not been delayed due to the minimum 14-day statutory required hold on all claims. Providers have the option to submit these claims, but payment will not be made until the hold is lifted. For telehealth services, flexibilities that were in place because of the public health emergency have expired, except for those for behavioral health services. Providers continuing to offer telehealth to Medicare patients should consider providing an Advance Beneficiary Notice of Noncoverage. Certain Medicare Shared Savings Program Accountable Care Organizations allow for telehealth services without geographic restriction, and those allowances remain in place. Providers are advised to monitor Congressional action and CMS for updates on claims processing and payments.
CISA Issues Emergency Directive to Federal Agencies to Address Threats to F5 Devices. The Cybersecurity & Infrastructure Security Agency (CISA) issued Emergency Directive ED 26-01: Mitigate Vulnerabilities in F5 Devices calling on Federal Civilian Executive Branch agencies to take action by installing newly released updates from F5 for F5 BIG-IP products. The Emergency Directive was the result of the compromise of F5 systems by a nation-state affiliated cyber threat actor. The vulnerability allows a threat actor to exploit F5 devices and software, which poses an imminent threat to federal networks using these. Federal agencies must: (i) Conduct an inventory for the affected devices and software; (ii) Apply the latest vendor updates for the affected products; (iii) Disconnect all public-facing F5 devices that have reached their end-of-support date; and (iv) Submit a complete inventory of F5 products and actions taken to CISA.
ASTP and RCE Launch TEFCA™ Topics in Change Management Resource Page. The Assistant Secretary for Technology Policy (ASTP), the Sequoia Project, the Recognized Coordinating Entity (RCE), and the Trusted Exchange Framework and Common Agreement™ (TEFCA™) governance bodies launched the TEFCA™ Topics in Change Management webpage. The intent of the project is to provide transparency into amendments to the Framework Agreements, technical requirements, and standard operating procedures (SOPs) in the change management process. An overview of the general change management process, as detailed in the Common Agreement, is provided. Items under consideration are listed with a status and next steps. Currently the Government Benefits Determination SOP and Exchange Purposes SOP v4.1 are listed with an approved version identified as forthcoming. Feedback on these documents is being accepted until October 31 and the caucuses are preparing to vote on the final versions.
Senate HELP Committee Holds Hearing on AI Potential. The Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing on October 9 titled “
AI's Potential to Support Patients, Workers, Children, and Families. Chairman Bill Cassidy, MD (R-LA) made opening remarks focused on the potential transformative benefits of artificial intelligence (AI) to improve patient care and decrease administrative burdens, and the risks to privacy and need for safeguards. Witnesses at the hearing addressed the use of AI in health care, education, and labor. Witnesses testified on various ways in which AI can accelerate and improve areas of clinical diagnosis, drug research, scientific breakthroughs, and patient education and engagement. Potential risks were also raised, including privacy breaches, adverse outcomes due to poorly trained AI systems, and security vulnerabilities.
Registration Open for 2025 MVPs, Deadline December 1. The Merit-based Incentive Payment System (MIPS) Value Pathways (MVP) registration window is open for the 2025 performance year. MVPs are a new option in the CMS Quality Payment Program for meeting the MIPS reporting requirement. The various MVP options for participation are available for review on the CMS Quality Payment Program MVP website. The deadline to register is December 1, 2025.
NY Piloting Statewide Encounter Notifications. The Statewide Health Information Network for New York (SHIN-NY) launched a pilot of real-time, statewide notifications of patients’ emergency department visits, hospital admissions, transfers, or discharges within the state. The service will give providers up-to-date information about patient encounters, which can improve care planning and decrease gaps in care. The notification alerts are transmitted through most electronic health records (EHRs) and can be seamlessly integrated into existing provider workflows. The goal is to expand the service to all SHIN-NY participants in early 2026. The launching of this service is the first of several planned initiatives by the group aimed at increasing health information sharing.
AMA Hosting CMS Innovation Center Webinar on New WISeR Model. The American Medical Association (AMA) is hosting a webinar on October 22 at 8:00 pm ET with leaders from the CMS Innovation Center on their new Wasteful and Inappropriate Service Reduction (WISeR) model. The model will implement prior authorization with the use of AI and machine learning technologies in the Medicare fee-for-service program for select services, including skin and tissue substitutes, electrical nerve stimulator implants, and knee arthroscopy for knee osteoarthritis. It is being piloted in Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington and will run for six performance years starting on January 1, 2026. The webinar will review the details of the model and allow attendees to ask questions. As a reminder, the government shutdown could impact this event.
Survey Results Reveal Increase in Clinician Satisfaction with EHRs. Black Book Research published results from surveys of 130,000 clinicians over 15 years showing improved clinician satisfaction in their electronic health record (EHR), up to 87% in 2025 compared to the first result of 11% in 2011. Clinicians that participated in the survey included physicians, registered nurses, pharmacists, therapists, radiology and lab technicians, and clinical support staff. The 2025 survey results identify satisfaction based on improved:
- Usability and ability to navigate in the EHR – 87%
- EHR support of clinical workflows – 90%
- Documentation tools – 93%
- IT support and system reliability – 70%
- EHR training – 88%
Researchers concluded from the results that there is a positive correlation between including clinicians in EHR design and higher clinician satisfaction scores of their EHR.