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Healthcare

Financial management and accounting solutions for healthcare businesses

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11 min read

The $120,000 Fertility Benefit: How to Account for America's Newest Standalone Employee Benefit

A proposed federal rule would let employers offer fertility coverage as a standalone excepted benefit — like dental or vision — capped at a combined $120,000 lifetime maximum per participant and covered beneficiaries, for plan years beginning on or after January 1, 2027. Here is how the fully insured and self-funded options differ on the books, and the ledger accounts, payroll deduction codes and accumulator reports to set up before the first enrollment.

Mike Thrift

employee-benefitshealth-insurancepayroll
10 min read

California SB 351: How Dental and Med Spa Practices Must Rebuild Their MSO/PC Books for 2026

California SB 351 took effect January 1, 2026, barring private equity and management companies from controlling clinical decisions at medical and dental practices. Because the violations it targets — percentage-of-collections management fees, clinician payroll in the MSO, patient revenue landing outside the PC — are all visible in the general ledger, compliance is largely a bookkeeping project. Here are seven ledger fixes to make now.

Mike Thrift

healthcarecaliforniacompliance
10 min read

Medical Spa Bookkeeping: Why Your MSO/PC Split, Membership Revenue, and Injectable Inventory Need Their Own Books

Med spas that book prepaid packages as day-one revenue, expense injectables on purchase, or run the MSO and PC through one bank account produce financials that fail audits and due diligence. This guide covers keeping separate books per entity with reconciled intercompany balances, recognizing package and membership cash as deferred revenue per delivered session, capitalizing neurotoxin and filler as inventory until use, and a monthly close checklist that ties POS unearned balances, physical counts, and management fees to the ledger.

Mike Thrift

healthcarebookkeepingrevenue-recognition
9 min read

Medicare Part D Creditable Coverage Notices: What Employers Must Send Before October 15

Employers with prescription drug coverage owe two annual disclosures — a creditable-coverage notice to Medicare-eligible participants before October 15, and an electronic filing to CMS within 60 days of the plan year start. Missing the notice can leave an employee paying a lifetime Part D penalty of 1% of the national base premium per uncovered month.

Mike Thrift

compliancehealth-insurancehealthcare
10 min read

The $15 Dispute: What the No Surprises Act's New IDR Rules Mean for Your Practice's Out-of-Network Revenue

The No Surprises Act's Federal IDR administrative fee fell from $115 to $15 per party for disputes filed on or after June 11, 2026, with the rest of the operations rule effective August 3, 2026. This guide walks a small medical practice through the arbitration timeline, why low-dollar out-of-network underpayments are now worth disputing, and how to book disputed receivables, dispute fees and awards so contested claims stop leaking revenue.

Mike Thrift

healthcarehealth-insuranceaccounts-receivable
10 min read

Selling Your Vet or Dental Practice to Private Equity? Your State May Now Get a Vote — and Your Books Will Get an Audit

Veterinary and dental practice owners weighing a private-equity sale in 2026 face new state transaction-review rules in New York and California, MSO/PC deal structures that regulators now read closely, and diligence that reprices adjusted EBITDA add-back by add-back. This guide covers the disclosure obligations, how cash, rollover, earnout and work-back slice the headline multiple, and the bookkeeping cleanup that protects your price.

Mike Thrift

healthcarebusiness-exitbusiness-valuation
16 min read

Association Health Plans in 2026: How Small Businesses Can Pool Together for Affordable Group Coverage

Association health plans could let small businesses and self-employed owners pool as a single large group under ERISA — median small-group premiums are proposed up 11% for 2026 and family coverage averages $26,993, while the Association Health Plans Act (S. 1847/H.R. 2528) would expand pooling with two-year association and nondiscrimination safeguards after the 2018 rule was rescinded in 2024.

Mike Thrift

health-insurancesmall-businessemployee-benefits
16 min read

PBM Reform Is Finally Law: What the 2026 Appropriations Act Means for Independent Pharmacy Reimbursement

Congress tucked sweeping PBM reforms into the Consolidated Appropriations Act of 2026 — banning spread pricing and rebate retention from 2028, mandating semiannual transparency reports, and creating any-willing-pharmacy and essential retail pharmacy protections from 2029. Here is what changes, when, and how to rebuild your books.

Mike Thrift

healthcarecompliancesmall-business
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