Federal Judge Blocks Key Trump-Era ACA Rule Provisions Impacting Coverage
A federal judge blocks major Trump-era ACA provisions that could lead to 1.8 million losing coverage, citing regulatory overreach and increased health costs.
CMS Extends Medicare Revalidation Deadline for Skilled Nursing Facilities to 2026
CMS extends the Medicare off-cycle revalidation deadline for skilled nursing facilities to January 1, 2026, maintaining the existing requirements. Providers should prepare to comply to avoid Medicare participation disruptions.
CMS Medicare Advantage Star Ratings: Regulatory Risks and Financial Impacts for Insurers
Explore how CMS's Medicare Advantage Star Rating system's opaque methodologies create regulatory arbitrage and financial risks for insurers like Elevance Health, Humana, and UnitedHealthcare, shaping the healthcare insurance landscape.
Federal Court Upholds CMS Medicare Advantage Star Ratings, Denies Elevance Health Lawsuit
Texas federal judge rules against Elevance Health in lawsuit over Medicare Advantage star ratings, impacting $375 million in bonus revenue. CMS methodologies upheld.
CMS Proposes 6.4% Medicare Payment Cuts to Home Health Agencies for 2026
CMS proposes a 6.4% cut in 2026 Medicare payments to home health agencies, driven by PDGM budget neutrality adjustments and expanding Medicare Advantage enrollment. HHAs must assess financial impacts, advocate, and optimize operations.
CMS Grants NTAP for Renata Medical's Pediatric Minima Stent System
CMS approves New Technology Add-on Payment for Renata Medical's Minima stent, enabling enhanced reimbursement for innovative pediatric congenital heart disease treatment.
CMS Proposes Major 2026 Medicare Rule Changes Affecting Inpatient Care and Outpatient Surgery
CMS 2026 outpatient rule proposes major changes including inpatient-only list elimination and expanded ambulatory surgery center procedures, impacting Medicare payment and compliance.
2026 Medicare Part D Updates: Premium Increases, Penalties, and Cost Caps
Explore the 2026 Medicare Part D updates including premium increases, delayed enrollment penalties, and maximum out-of-pocket caps for prescription drugs, with insights into Medicare Advantage plan impacts.
CMS Proposes Voluntary Medicaid and Medicare GLP-1 Coverage Trial
CMS plans a voluntary five-year trial allowing state Medicaid and Medicare Part D plans to cover GLP-1 weight management drugs, including Ozempic and Wegovy, starting in 2026-27 amid pricing and coverage challenges.
Senators Propose Bill to Tighten Medicare Advantage Risk Adjustment, Curb Overpayments
Senators introduce bipartisan bill targeting Medicare Advantage overpayments by refining risk adjustment and supporting CMS audits to enhance program integrity and save Medicare billions.