#healthcare
Financial management and accounting solutions for healthcare businesses
The FTC's July 2026 settlement with CVS Caremark requires a cost-plus reimbursement option, point-of-sale rebate pass-through, and delinked PBM fees. Here is how independent pharmacies should model the switch, track DIR clawbacks, and keep reimbursement data auditable.
Medical billing companies are agents under ASC 606: revenue is the 4–8% fee on collections, not the gross payments passing through. How to book pass-through cash as a liability, build a chart of accounts around fee income, and track clean-claim rate, denial rate, and days in A/R as leading indicators.
Initial claim denial rates reached 11.8% in 2026, and billing services paid 4–10% of collections absorb every denial in their own books. A practical guide to recognizing fee revenue when claims actually pay, tracking denial rework as a separate cost, segregating client trust funds, and building a chart of accounts for a contingent-fee business.
DOL Opinion Letter FLSA2026-8 holds that integral pre-shift work like patient handoffs is compensable, narrows the de minimis defense when timekeeping systems record punches to the minute, and requires rounding policies to be genuinely neutral — a compliance guide for any employer with hourly workers.
On June 3, 2026, the Third Circuit ruled in Secretary of Labor v. Comprehensive Healthcare Management Services that the FLSA provides no federal remedy for "overtime gap time" — hours worked but paid at neither straight time nor the overtime premium — aligning with the Second Circuit and deepening a split with the Fourth. Here's what gap time is, why state wage laws still create exposure, and five payroll checks every small employer with hourly staff should run.
Senior living placement agencies earn 70–80% of a resident's first month's rent — but only at move-in, and often subject to 30-day clawback clauses. This guide explains when to recognize referral fee revenue under ASC 606, how to book refund liabilities from your historical clawback rate, and which pipeline metrics predict cash flow.
Urgent care bookkeeping hinges on details generic templates miss: the POS-20 place-of-service code that sets the reimbursement rate (and triggers denials at payers who contract clinics as offices), denial-reason tracking for the ~60% of billing work that happens after claim submission, and Section 179's $2,560,000 limit plus permanent 100% bonus depreciation for X-ray and lab equipment in 2026.
DOL Opinion Letter FLSA2026-1 (January 5, 2026) confirms employers may voluntarily classify an overtime-exempt learned professional as non-exempt, because non-exempt status is the FLSA default. Here's what the letter says, the three-prong exemption test under 29 CFR § 541.301, and a practical reclassification checklist for small businesses.
New Jersey's A5324, effective July 1, 2026, bills employers $325–$725 per year for each Medicaid-enrolled employee or dependent once 50 or more are enrolled — matched by the state, not self-reported. Here is how the tiered fees work, which workers are exempt now and in 2027, and how to prepare your books for a bill you didn't calculate.
As of January 1, 2026, CMS-0057-F requires Medicare Advantage, Medicaid, CHIP, and ACA marketplace payers to decide prior authorization requests within 72 hours (expedited) or 7 calendar days (standard) and to give specific denial reasons — with FHIR-based prior auth APIs mandated by January 1, 2027. Here's what small medical and dental practices should do now.
Home care agencies collect from private pay, Medicaid MCOs, and VA Aid and Attendance on three different timelines while caregiver payroll runs on a fixed biweekly schedule, so tracking AR by payer separately (not blended) is the key to forecasting cash and catching the 2026 EVV hard-edit denials that make unresolved visit exceptions permanently unbillable.
Med spas that book prepaid packages, gift cards, and membership fees as revenue at the point of sale overstate income and understate the deferred-revenue liability they owe clients — with the U.S. med spa industry at roughly $21.4 billion in 2026 and package sales now about 29% of client spending, the resulting distortion can turn a strong bank balance into an unexplained cash crunch two months later.
