CMS finalized a 2024 rule narrowing Medicare custody to physical confinement, expanding Medicare coverage for community-supervised individuals starting 2025.

The $50 billion Rural Health Transformation Program aims to strengthen rural health care but faces challenges in implementation and funding amid federal Medicaid cuts, impacting states, providers, and rural communities.

CMS proposes 2.4% Medicare payment increase for outpatient and surgery centers in 2026 with a new two-tier physician payment model to promote value-based care participation, amid concerns over long-term financial sustainability for providers.

CMS initiates survey collecting hospital outpatient drug acquisition costs to align Medicare payments with actual costs under the 2026 OPPS update, following a federal Executive Order to reduce prescription drug expenses.

Dr. Mehmet Oz discussed the role of healthy eating in sustaining Medicare during the program's 60th anniversary, highlighting the intersection of preventive health and insurance policy.

UnitedHealth Group emphasizes strict regulatory compliance and audit accuracy in Medicare Advantage operations following scrutiny by The Wall Street Journal. CMS audits confirm coding integrity and adherence to federal guidelines.

Applied Policy names Brittany La Couture as VP of Health Policy, leveraging her Medicare Advantage and CMS expertise to enhance pharmaceutical reimbursement strategies.

Federal court ruling raises Alignment Healthcare's Arizona Medicare Advantage star rating to 4 stars, impacting quality ratings and bonus payments in 2025.

Survey by Civitas Networks for Health shows Medicare Quality Improvement Organizations generated $4.7B savings and highlights recommendations for program enhancements focusing on data interoperability, onsite training, and workforce retention.

CMS launches a six-year pilot requiring pre-authorizations for 17 medical services in traditional Medicare across six states, aiming to control costs and reduce service overuse.