CMS Launches ACCESS Model to Advance Technology-Enabled Chronic Care in Medicare
CMS introduces ACCESS model to enhance technology-supported care and outcome-based payments for Medicare patients with chronic conditions starting in 2026.
Humana Appeals CMS Over Medicare Advantage Star Ratings Dispute
Humana appeals CMS over Medicare Advantage star ratings, contesting calculation methods and evaluation processes affecting bonuses and plan ratings.
CMS Proposes 2027 Medicare Advantage Rule Updates on Star Ratings, Risk Adjustment, and Reporting
CMS released 2027 proposed Medicare Advantage rules focusing on simplifying Star Ratings, expanding risk adjustment data use, and streamlining reporting requirements.
U.S. Healthcare Policy and Medicare Updates Shape 2026 Insurance Outlook
Key updates on Affordable Care Act premium tax credits, Medicare regulations, and healthcare funding shape U.S. insurance policy outlook for 2026 amid pending legislative deadlines.
CMS Launches AI-Driven Prior Authorization Model for Traditional Medicare in 2026
CMS to implement the WISeR Model in 2026, using AI tools for prior authorization in traditional Medicare, aiming to streamline utilization management and control costs.
CMS Ends Kidney Care Payment Model, Updates Home Health and Chronic Care Initiatives
CMS will end the kidney care payment model early and adjust Medicare home health reimbursements in 2026. A new 10-year program supports tech adoption for chronic disease management.
CMS Renews Contract with Quest Analytics for Medicare Advantage Network Oversight
The Centers for Medicare & Medicaid Services renews Quest Analytics contract to enhance Medicare Advantage network adequacy reviews and compliance oversight for better access to care.
Medicare Home Health Reimbursement Cuts Reduced to $220M for Next Year
CMS cuts Medicare home health reimbursement by $220M in 2025, less than the proposed $1B reduction. Providers highlight sustainability concerns under current payment model.
CMS Finalizes 1.3% Medicare Home Health Payment Cut for 2026 Amid Industry Concerns
CMS finalizes a 1.3% Medicare payment cut to home health agencies for 2026, highlighting industry concerns over reimbursement declines, workforce impacts, and care access challenges.
CMS Proposes 2027 Medicare Advantage Rule; Drug Price Negotiations Advance
Summary of recent CMS proposals affecting 2027 Medicare Advantage and Part D, plus updates on Medicare drug price negotiations impacting federal health programs.