ImagineSoftware™ recently welcomed two of the most connected voices in healthcare policy – Brad Lund, Executive Director of the Healthcare Business Management Association (HBMA), and Matt Reiter, HBMA’s Director of Government Affairs – for a powerful conversation on the intersection of policy, regulation, and revenue cycle management (RCM). From Capitol Hill to CMS, the duo unpacked how HBMA’s ongoing advocacy impacts providers, billing companies, and patients alike.
The Role of Advocacy in RCM: Beyond Education
Brad Lund kicked off the webinar by reinforcing HBMA’s dual mission: to educate the RCM industry and to advocate on its behalf. “We commit up to 10% of our annual budget to advocacy,” Lund shared, “and we maintain a physical presence in Washington, D.C. to ensure our voice is heard.”
Matt Reiter, who has worked with HBMA for over a decade, emphasized that advocacy is far from one-sided. “I’m not just the voice of HBMA to Congress and CMS – I’m also the eyes and ears for our members. Advocacy is a two-way street,” he explained.
How RCM Companies Shape Healthcare Policy
According to Reiter, one of the biggest misconceptions among policymakers is underestimating how much operational responsibility falls on RCM companies. “Most federal policies are written for ‘providers,’ but it’s often the RCM companies implementing those policies day-to-day,” he said. That reality makes HBMA an essential partner in shaping workable regulations and laws.
He illustrated this with a recent example: “During the fallout from the Change Healthcare cyberattack, lawmakers and agencies sought our input to inform cybersecurity proposals.” Reiter’s relationships with policymakers allow HBMA to guide decisions before they become burdensome mandates.
Inside the “One Big Beautiful Bill” and Its Impact on Healthcare
A major portion of the discussion focused on the recently passed legislation of the “One Big Beautiful Bill Act” (H.R.1), a sweeping tax and healthcare package passed through budget reconciliation.
“This bill permanently extends many 2017 tax cuts and includes a 2.5% Medicare payment increase for physicians in 2026,” Reiter explained, referencing the proposed Medicare Physician Fee Schedule. “But it also introduces complex Medicaid eligibility changes that could lead to millions losing coverage.”
He also noted what the bill left out: “The inflationary update for Medicare payments, which we’ve long advocated for, was stripped out. That’s disappointing, but we’re hopeful it’ll return in future legislation.”
Regulatory Reality: From No Surprises to HIPAA Overhauls
Regulatory interpretation often deviates from congressional intent – a dynamic the speakers illustrated using the No Surprises Act (NSA). “Congress intended NSA to create a neutral IDR process,” said Reiter. “But CMS gave undue weight to the median in-network rate, essentially overriding other factors. That led to successful legal challenges, and we’ve pushed CMS to course correct.”
The conversation also highlighted future regulations, including changes to HIPAA standards and cybersecurity proposals following the Change Healthcare incident. “Rather than reinventing the wheel,” said Reiter, “we recommended building on existing voluntary guidelines.”
AI in Healthcare: The Wild West (For Now)
On the topic of artificial intelligence, Reiter described a policy vacuum. “There’s no federal framework restricting how health plans or RCM companies use AI,” he said. “We’re in a phase of unrestricted experimentation.”
Though optimistic about AI’s potential, Reiter offered a pragmatic take: “Entities will use AI to do what they already do – only faster. For health plans, that may mean denying claims more efficiently. For RCM companies, it could mean automating appeals or streamlining workflows.”
What’s Ahead: Congressional Focus and the “Musk Effect”
As the webinar drew to a close, Reiter addressed several active legislative priorities:
- Telehealth: Congress is expected to temporarily extend COVID-era telehealth flexibilities, though permanent reforms remain uncertain.
- PBM Reform: Pharmacy Benefit Manager legislation could serve as a budget offset for physician payment increases.
- Medicare Advantage Scrutiny: Unexpectedly, the current administration is auditing MA plans more aggressively than anticipated.
Reiter even coined a new term – the “Musk Effect” – to describe the outsized influence of public figures in derailing major legislative packages, referencing Elon Musk’s role in tanking a prior year-end funding bill.
Advocacy as a Continuous Conversation
The webinar ended with a powerful reminder of advocacy’s role in shaping sustainable, scalable healthcare operations. “This is not a transactional relationship,” Reiter said. “It’s about showing the value we bring – and earning the trust of policymakers over time.”
Lund echoed this sentiment: “HBMA represents over 125 specialties. We’re not a special interest group – we represent the provider community at large.”
Want to Learn More?
For ongoing updates, HBMA members can access the Washington Report and Capital Insights, while non-members are encouraged to follow credible policy journalists and organizations on social media platforms like X (formerly Twitter). As Reiter put it: “You have the power to curate your sources. That’s how you stay ahead.”
