CMS updates Medicare Advantage policy to allow insurance coverage for federally and state-legal CBD products, amid evolving hemp regulatory definitions and market challenges.
CMS's WISeR Model introduces AI-powered prior authorization for Medicare outpatient procedures, impacting approval times and denials in six states starting 2026.
CMS releases Proposed 2027 Rules for Medicare Advantage and Part D, emphasizing Star Ratings simplification, marketing oversight updates, expanded risk adjustment data use, and Part D redesign implementation.
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, contesting calculation methods and evaluation processes affecting bonuses and plan ratings.
CMS released 2027 proposed Medicare Advantage rules focusing on simplifying Star Ratings, expanding risk adjustment data use, and streamlining reporting requirements.
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 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 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.
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.
