CMS finalizes the 2026 Medicare OPPS and ASC payment rates with a 2.6% increase, including quality reporting penalties and maintained 340B payment adjustments.

Medicare 2026 premiums surge nearly 10%, with fewer Medicare Advantage plans as insurers scale back. Explore key Medicare cost drivers and market impacts.

Wellcare expands Medicare Advantage coverage to 51 million beneficiaries and transitions Medicare-Medicaid Plans to integrated Dual Eligible Special Needs Plans in 2026, enhancing care coordination.

Health First Urgent Care agrees to $2.8 million settlement for Medicare and Medicaid overbilling linked to improper diagnostic test billing practices in Washington State.

The DOJ expands its Health Care Fraud Strike Force to Massachusetts, enhancing multi-agency efforts against healthcare fraud and corporate misconduct in the healthcare sector.

Medicare Part D's coverage gap, known as the Donut Hole, is eliminated in 2025 with a new three-phase benefit and $2,000 out-of-pocket cap, enhancing cost predictability and managing prescription drug expenses for beneficiaries.

Federal report exposes inflated mental health provider directories in Medicare Advantage and Medicaid managed care plans, highlighting access challenges and regulatory compliance issues.

CMS unveils the GENERous Medicaid payment model introducing MFN drug pricing, alongside expanded Trump administration drug pricing agreements and key regulatory updates for 2026.

Explore how the expansion of Medicare Advantage plans affects rural hospitals, reimbursement rates, patient access, and marketing practices impacting Medicare beneficiaries and healthcare providers in the U.S.

The CMS-funded GUIDE Program enhances dementia care with coordinated, personalized support for Medicare beneficiaries and caregivers in community settings.