AMAZING APDA NEWS!
Thanks to the efforts of our Fantastic Board, CGA and Loyal members, APDA keeps scoring for our members and the industry......
FINAL 2026 R0070 RATE
Most MACs have published their final 2026 Portable Transporation rate. To see your MAC rates go to:
FOR MEMBER'S ONLY - Log in and go to Resources tab/Medicare to view rates.
ANOTHER BIG STEP FOR THE PURE ACT! Our PURE Act has made the Energy and Commerce Committee hearing list of topics for Improving Medicare Payment Policies for Seniors. Hearing took place on January 8, 2026-Read More for a recap of the hearing and the latest updates.
GREAT NEWS! PRESS RELEASE! Big step in Ultrasound Transport & Set up Reimbursement..
Today 3/27/2025 Congresswoman Beth Van Duyne (R-TX-24) was joined by her colleagues, Representatives Brad Schneider (D-IL-10), Mariannette Miller-Meeks (R-IA-01), and Lori Trahan (D-MA-03), and Senators John Cornyn (R-TX) and Maggie Hassan (D-NH), in reintroducing the Portable Ultrasound Reimbursement Equity Act (PURE Act).... We have a Bill!
Follow the PURE ACT - As of December 15, 2025 we have 33 co-sponsors
Watch our Bill gain support - Click below
Cosponsors: H.R.2477 — 119th Congress 2025-2026
What can you do to make sure this bill is passed and we start receiving reimbursement ASAP?
Contact your representatives and ask for their support to co sponsor the PURE ACT. It is exciting to see our list of co-sponsors continue to grow every day.
APDA'S WORK FOR ITS MEMBERS AND THE INDUSTRY CONTINUES TO PAY OFF!
JOIN THE TEAM & MAKE A DIFFERENCE FOR YOUR BUSINESS & THE INDUSTRY!
TAKE ACTION! JOIN APDA PAC
We ask for your help in making noise on the Hill to EDUCATE our representatives and the healthcare industry on Portable Diagnostics and its value (avoiding unnecessary hospital visits by bringing x-rays & diagnostics to the elderly-saving lives & money), ADVOCATE for fair and equal transportation reimbursement for ALL states and PUSH for Fair inclusion in policies that matter to our patients & industry.
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MEMBERS ONLY: Are you looking for guidance on policies, billing issues & more? Sign on to this website & go to the Resources tab for information on policies and procedures for Medicare, CMS, Advantage plan, Regulations & more. This resource is for Members Only.
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On November 25th, 2025, Dr. Oz issued a letter to all 50 states and Washington D.C. encouraging them to partner with CMS to take action against healthcare providers and suppliers who commit healthcare and tax fraud. Healthcare providers who bill fraudulent insurance claims often fail to report the associated income on their tax returns, creating a dual-layered crime that drains both federal and state tax systems. This initiative will strengthen state-federal enforcement against fraudulent Medicare providers and suppliers. A copy of the letter that was sent to states is available here.
Members FYI - Have you or do you intend to purchase ABI testing equipment??? Be aware of what you are purchasing and make sure it meets Medicare guidelines. CMS is now recouping Millions from providers due to Medical device companies that misrepresent the capabilities of their products and encourage providers to bill Medicare for services that do not meet coverage requirements. Read OIG case
February 16, 2026-New HIPAA Rules go into affect - Read more
February 4, 2026 CMS increases focus on Nursing Home Medical Directors compliance-Will the focus also turn to ancillary provider's compliance with Supervisory physicians?
January 29, 2026 Premier Radiology aquires Teleradiology group NRad
January 27, 2026 Update your Notice of Privacy Practice-effective February 16, 2026
January 25, 2026 California man pleads guilty in $54M in Radiology and Hospice care fraud scheme
January 22, 2026 Medicare Advantage Payments exceed FFS by $76B
January 21, 2026 TridentCare Announces Acquisition of Dispatch Health
January 16, 2026 Medicare payment advisors urge Congress to increase Radiologist reimbursement
January 15, 2026 Five Ophthalmology Practices Agree to Pay Nearly $6M to Resolve Allegations of Fraudulent Claims to Medicare and Medicaid for Cranial Ultrasounds performed by a 3rd party testing company The practices paid the third-party testing company based on the volume or value of tests ordered and referred the patients to the testing company’s preferred radiology group for the ultrasounds’ professional component, according to the release.
January 15, 2026 Med PAC recommends to cut Skilled Nursing Home reimbursement by 4% and Home Health reimbursement by 7%
January 15, 2026 CMS changes onsite inspection contractors as of January 3, 2026
January 14, 2026 Google rolls out 2 new open access AI models aimed at Medical Imaging
January 8, 2026 OIG Focus on Nursing Home engagement of Medical Directors
OIG and Department of Justice (DOJ) have aggressively pursued nursing homes and related entities for sham medical director arrangements that violated the Anti-Kickback Statute and False Claim Act.
January 1, 2026 Medicare starts the WisER Model-?prior authorizations required for certain procedures.
Starting Jan. 1, doctors in New Jersey, Ohio, Oklahoma, Texas, Arizona and Washington will have to get extra approval before Medicare pays them for certain outpatient services and procedures.
December 23, 2025 Insurers fudging payment estimates for Radiology services under the No Surprises Act
December 10, 2025 CMS to suspend SNF Medicare revalidations indefinately
December 5, 2025 Members on the move-Portable diagnostics on the move in Houston
December 5, 2025 CMS tightens Audit oversight, especially in the SNF environment-due to poor documentation
WASHINGTON, D.C. – Today, U.S. Representatives Mark Pocan (WI-02), along with 12 other members, introduced a package of eight bills that apply guardrails to Medicare Advantage (MA) programs while strengthening traditional Medicare.Addresses delays/denials, right to rapid appeal and fraud accountability.
November 10, 2025 Competitors collaborating in the Radiology World
This is the CareFlow Club, a gathering of AbbaDox clients that brings together imaging center operators who would typically view each other as rivals.
November 7, 2025 Update on processing of telehealth claims after October 1, 2025
November 4, 2025 Want to laugh? - see this video satire on Medicare Advantage!
November 3, 2025 Hackers steal medical records & financial data from 1.2M patients in massive Radiology Group Breach
October 21, 2025 CMS lifts claims hold on Physician Fee Schedule, other claims amid Government Shutdown
October 15, 2025 Medicare halts claim processing - then later reversed course and said claims would be paid in a "timely manner" except claims for expired programs. "most claims
October 14, 2025 Radiology platform startup OneImaging raises $38M in series A financing - Could PXR providers join?
OneImaging seeks to simplify radiology appointments for patients and providers, connecting them with a nationwide network of accredited centers.
October 1, 2025 Will the Government Shut Down that started today affect our claims?
A government shutdown is not expected to impact Medicare payments to health care providers, i.e., Medicare Administrative Contractors will continue to process and pay Medicare claims. However, past government shutdowns have impacted other Medicare operations, including provider enrollment and pre- and post-payment audit activities. Providers that are currently in the process of enrolling and/or revalidating their Medicare enrollment may experience delays in the processing of these applications. Learn More-MLN Connect
September 24, 2025 Hospital at Home program due to expire 9/30/25 - What are the hopes of an extension?
September 21, 2025 Leading Age/SNFs push legislation to eliminate SNF 3 day Rule due to elimination of 285 procedures from the Inpatient only list-beginning in 2026. Will that increase or decrease Part A billing?
September 21, 2025 Over half of providers forgo physical exams before ordering imaging - making it difficult to prove medical necessity during an audit
July 9, 2025 Premier Radiology acquires another rival telerad group
September 14, 2025 The higher cost of Advantage Plans - Longer Hospital stays for skilled nursing transfers -“Extensively documented barriers to discharge in Medicare Advantage due to prior authorization or more limited postacute care networks..."
September 10, 2025 FTC Chairman Ferguson Issues Non compete warning letters to Healthcare employers
“We strongly encourage all employers—not just those receiving letters today—to review their contracts closely, to ensure that any restrictions on employee mobility are in full compliance with the law.”
September 9, 2025 Instead of closing their doors or selling, Rural Hospitals survive by banding together - utilizing Mobile Diagnostics and taking advantage of funding from the $50 billion Rural Health Transformation Program—part of President Donald Trump’s recent tax and spending bill—can be used to help start or expand such organizations.
Septermber 8, 2025 Medicare Advantage patients experience longer hosptial stays compared to traditional Medicare Patients
September 5, 2025 HHS announces Crackdown on Providers failing to share Radiology results
August 28, 2025 30% of Nursing Homes Daily Medicare Advantage denials / delays to post acute care
August 22, 2025 Starting January 2026, CMS expands prior authorization in original Medicare
August 8, 2025 AI screening for osteoporosis via chest xray is cost effective and feasible
August 4, 2025 Medical imaging a heavy contributor to Medicare waste, study finds
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SAVE THE DATE........
APDA CAPITOL HILL FLY-IN
MAY 4-6, 2026
Details coming soon
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Associate Business Members!
Thank you APDA ABM Sponsors!
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2026 Educational Webinars
Free for APDA Members!
Details coming for 2026
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4May
APDA 2026 Conference Fly-In
5/4/2026 to 5/6/2026 EDT
Blog
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Portable Diagnostics Touching Lives - Rene's Mother
Rene's Mother Rene Steven of Wichita, Kansas is grateful for the many services that portable diagnostics have been able to provide her mother, Esther Steven. At 91, Esther is truly remarkable. After raising 11 children, she has been blessed with numerous grandchildren and great...
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$18 Billion in Cost Avoidance - The Math Behind the Number
Overview: The stated goal of Patient Protection and Affordable Care Act (PPACA) (i.e. Obamacare) and Health Care Reform is what people like to call the Triple Aim. As you know, the Triple Aim was designed to: Improve patient satisfaction and quality of care Improve...
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Portable X-Rays Changing Lives - Sharon's Mother
Independent portable x-ray providers live in the communities they serve and become an integral part of elder care in that community's nursing homes and other facilities housing frail and vulnerable patients.
Read More »