CMS issues proposed rule for 2027 Medicare Advantage and Part D, including STAR rating updates, special enrollment flexibilities, and enhanced data access. Comments due Jan 2026.

CMS increases Medicare audits in nursing homes following a rise in improper payments to 17.2% in 2024, urging better documentation and compliance to avoid denials and penalties.

The OIG report reveals Medicare overpayments on continuous glucose monitors and supplies, supporting CMS competitive bidding changes to reduce costs and improve payment models in home medical equipment.

CMS introduces the ACCESS Model to improve Medicare chronic care with digital health innovation and outcome-based payments starting 2026.

CMS initiates the ACCESS Model, a 10-year voluntary program testing outcome-based payments for Medicare fee-for-service providers, enhancing integrated, tech-supported chronic care.

CMS's finalized Medicare payment rule for home health agencies reduces payments by 1.3% and revises payment methodology following industry feedback, signaling modest future increases but immediate financial challenges.

CMS announces a 9.7% increase in Medicare Part B premiums for 2026, affecting individuals earning $109,000 or less. Updates on oncology drug reimbursement and legal challenges to the CMS 340B drug rebate pilot program highlight shifting dynamics in Medicare regulation and healthcare compliance.

CMS has secured significant price reductions on 15 drugs including costly cancer treatments, impacting Medicare Part B pricing and healthcare costs.

The Medicare Diabetes Prevention Program has enrolled less than 1% of eligible beneficiaries since 2018 due to administrative, referral, and awareness challenges despite proven effectiveness. CMS changes aim to improve access and provider reimbursement.

CMS expands Medicare drug price controls to 25 medications, achieving $12 billion savings with new Maximum Fair Prices starting 2026 and 2027 for chronic and cancer treatments.