Medicare telehealth waivers and hospital-at-home programs expired on Sept. 30, risking reduced access to telehealth services for Medicare patients and operational pauses in hospital-at-home programs. Stakeholders call for permanent regulatory solutions.

CMS proposes to revamp Medicare Advantage Star Ratings, affecting insurer compliance and operations. Legal appeals and health system updates also impact the US market.

Medicare 2026 premiums surge nearly 10%, with fewer Medicare Advantage plans as insurers scale back. Explore key Medicare cost drivers and market impacts.

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.

CMS issues National Coverage Determination for FDA-approved renal denervation treatment under Coverage with Evidence Development for uncontrolled hypertension in Medicare patients.

Federal court upholds CMS's star rating methods after Humana challenges foreign language interpreter test policy, impacting Medicare Advantage market competition and insurer revenues.

CDPHP earns top NCQA and CMS 4.5-star ratings in 2025 for commercial and Medicare health plans, highlighting strong quality and member care in New York's insurance market.

The American Hospital Association urges CMS and HHS to enforce prior authorization reforms to reduce hospital staff workload and patient delays, emphasizing implementation of electronic standards and monitoring compliance.