CMS unveils the GENERous Medicaid payment model introducing MFN drug pricing, alongside expanded Trump administration drug pricing agreements and key regulatory updates for 2026.
The U.S. government passed H.R. 5371, ending the shutdown and extending Medicare telehealth flexibilities through January 2026, ensuring continued coverage and retroactive payments for telehealth claims.
CMS introduces the Ambulatory Specialty Model, a new mandatory payment model for specialists treating low back pain and heart failure, effective from 2027 to improve care quality and reduce costs.
Medicare Part B premiums will increase by nearly 10% in 2026, consuming much of seniors' Social Security COLA and raising out-of-pocket costs amid regulatory efforts to control spending.
CMS issues National Coverage Determination for FDA-approved renal denervation treatment under Coverage with Evidence Development for uncontrolled hypertension in Medicare patients.
CMS finalized the 2026 Medicare Physician Fee Schedule with minor reforms and introduced an interactive dashboard tracking payment rates across Medicare payment systems starting January 2026.
Health insurance premiums in rural America could increase by over $1,300 monthly in 2026 if Biden-era ACA marketplace subsidies expire. This change would impact millions of rural residents, highlighting disparities and market risks ahead of budget negotiations.
A federal judge upheld CMS Medicare Advantage star ratings, resulting in a downgrade for Humana that risks billions in government bonus payments. The ruling affects nearly half of Humana's Medicare Advantage members and has broad implications for the insurer and Medicare market.
CMS limits Medicare payment delays to specific services amid federal shutdown, focusing on telehealth funding lapses and advising providers on claims submissions and patient billing options.
Explore the latest 2025 Medicare Advantage policy updates, including CMS rule changes on prior authorization, risk adjustment models, Star Ratings, supplemental benefits, provider directories, and marketing oversight.
