HHS-OIG Flags $39.6M in Podiatry E/M Billing for CMS Oversight
HHS-OIG audit uncovers $39.6 million in potentially improper podiatry E/M payments, urging CMS to enhance Medicare oversight in billing practices.
CMS Launches 2026 Drug Acquisition Cost Survey for Medicare OPPS Hospitals
CMS will conduct a drug acquisition cost survey in early 2026 to collect data from hospitals under the Medicare OPPS, informing 2027 outpatient payment policies.
CMS Launches ACCESS Model to Advance Medicare Chronic Care with Digital Tools
CMS introduces the ACCESS Model to enhance chronic care for Medicare beneficiaries using digital health tools and outcome-based payment models starting in 2026.
GAO Identifies Fraud Gaps in ACA Marketplaces Allowing Fake Enrollment
GAO report reveals fraud vulnerabilities in ACA marketplaces with fake enrollments approved in 2024-25, urging stronger fraud controls and verification in federal marketplaces.
CMS Announces 2027 Medicare Part D Drug Price Reductions for 15 High-Cost Medications
CMS reveals new 2027 price caps for 15 Medicare Part D drugs, projected to save billions federally and reduce patient costs under the Inflation Reduction Act negotiations.
CMS Launches ACCESS Model to Advance Technology-Enabled Chronic Care in Medicare
CMS introduces the ACCESS Model, a voluntary Medicare initiative that promotes technology-enabled chronic care solutions to improve patient outcomes and modernize Medicare treatment frameworks.
CMS Proposes Major Reforms to Medicare Advantage and Part D for 2027
CMS unveils significant Medicare Advantage and Part D changes for 2027, including Star Ratings overhaul and increased quality bonus payments, impacting Medicare spending by $14B.
CMS Finalizes 2026 Payment Updates and Policy Changes for OPPS and ASCs
CMS announces 2026 updates for OPPS and ASC payment systems, including expanded site neutral payments, skin substitute product unbundling, IPO list phase-out, and new hospital price transparency requirements.
CMS Proposes Major 2027 Medicare Advantage and Part D Updates Following Inflation Reduction Act
CMS's 2027 proposed rule outlines key Medicare Advantage and Part D program updates, codifying Inflation Reduction Act changes, adjusting Star Ratings, and modernizing marketing and risk adjustment frameworks.
OIG Finds Medicare Overpaying for Continuous Glucose Monitors; Recommends Payment Cuts
OIG report identifies Medicare overpayments for continuous glucose monitors and urges CMS to reduce payment rates, highlighting potential savings.