Here is the latest update on the H1N1 influenza virus (or, the swine flu) outbreak from the CDC. The number of reported cases has reached more than 5,000 with nine deaths. Subscribers can read our coverage, which includes Medicare billing advice, here and here.

Republicans jumped into the center of the health care debate with a reform proposal called the Patients' Choice Act on May 20. Sens. Tom Coburn MD (R-Okla.) and Richard Burr (R-N.C.), and Reps. Paul Ryan (R-Wisc.) and Devin Nunes (R-Calif.) introduced the legislation, saying it "delivers on the shared principles of promoting universal access to quality, affordable health care, and does so without adding billions of dollars in new debt or taxes."

The U.S. Attorney General and HHS will apply anti-crime methods -- used to fight Medicare fraud in Los Angeles and Miami -- to Houston and Detroit, officials announced May 20. Attorney General Eric Holder and HHS Secretary Kathleen Sebelius announced the Health Care Fraud Prevention and Enforcement Action Team (HEAT) will target those cities, but no timeframe was given in a statement sent out to reporters.

It's been a year of major changes for Medicare enrollment, from the widespread availability of CMS's online PECOS enrollment system to strict new timeframes for submitting applications. If you thought it was tough to get through the mazelike Medicare enrollment process before, think again: enrollment is a whole new animal in 2009 and it's not better to deal with.

The Ambulatory Surgery Center (ASC) Association reports CMS will allow an exception to new prior notification rules.

On May 18, CMS required ASCs to provide patients with advance notice and information on their rights and any physician financial interest in the ASC before the date of a surgery -- with no exceptions (subscribers can read more, here). But now CMS has posted an exception in a May 15 memo on "State Operations Manual (SOM) Appendix L, Ambulatory Surgical Centers (ASC) Comprehensive Revision."