Blogs

CMS 2026 Final Rule brings major changes to Medicare billing—stricter prior authorization rules, complex dual-eligible modifiers, and new Part D pharmacy requirements. While the updates aim to streamline care, they also increase the risk of denials and documentation errors. From missing appeal codes to rejected scripts, providers face more compliance pressure than ever. That’s where Pyramids Global steps in. We simplify the complexities with smart audits, real-time updates, and claim-ready tools tailored to CMS 2026 standards—helping clinics stay compliant, reduce denials, and get paid faster in an ever-changing billing landscape.

Trump’s Health Equity office shutdown has ignited legal turmoil and widespread concern among providers. The closure of key minority health offices under CMS and HHS disrupts billing guidance, equity-focused coding, and care for underserved communities. With critical data pipelines severed and staff ousted, providers face rising denials and audit risks. What once offered clarity—like rural telehealth modifiers and social determinant “Z codes”—is now gone. As disparities grow invisible, Pyramids Global steps in, offering coding expertise, audit protection, and regulatory updates to help clinics navigate this chaos and safeguard vulnerable patient populations.

Trump’s Healthcare Tech push is moving fast—with big changes for providers. From AI initiative to extended telehealth rules and expanded home-based hospital care, these policies bring both opportunity and complexity. New billing codes, compliance rules, and hybrid care models are already creating challenges. That’s where Pyramids Global steps in. We simplify AI billing, flag telehealth errors before claims go out, and decode home care coding. As tech transforms healthcare, we help you stay ahead—so you can focus on patients, not paperwork. Let us handle the red tape.

As states push for Medicaid work requirements, healthcare providers face new billing complexities. States like Arkansas and Ohio aim to enforce work, study, or volunteer mandates for benefit retention, risking coverage loss for non-compliance. Pyramids Global steps in to simplify this chaos. They ensure compliance by staying updated on state-specific rules, defending documentation during audits, correcting coverage errors swiftly, and keeping patients informed. By partnering with Pyramids Global, providers can focus on care while minimizing financial disruptions from policy changes.

Big news for heart care: Medicare now covers transcatheter tricuspid valve replacement (TTVR) but only under strict CMS conditions. Hospitals must use FDA-approved TTVR for severe tricuspid regurgitation, form specialized heart teams, and enroll patients in CMS-backed studies tracking outcomes for 24 months. Compliance errors can lead to denied claims and lost revenue. Pyramids Global steps in with compliance checks, heart team coordination, documentation support, and audit prep, transforming regulatory challenges into streamlined workflows. Stay focused on innovation while Pyramids Global handles the billing maze.