CMS introduces the MAHA ELEVATE Model to finance lifestyle and functional medicine interventions in Original Medicare, targeting chronic disease prevention and cost reduction.

A 2024 GAO report reveals ongoing challenges with unauthorized ACA plan enrollments and plan-switching fraud despite new CMS safeguards, emphasizing the need for stronger identity verification and regulatory measures.

Medicare premiums and deductibles will rise in Wyoming next year, intensifying financial pressures on fixed-income seniors despite a Social Security increase. Learn how these changes affect affordability and senior healthcare access.

CMS has repealed the 2024 minimum nursing home staffing requirements, removing mandated staff-to-resident ratios but maintaining enhanced assessment protocols. This change impacts long-term care quality regulations and remains effective in February 2026.

CMS Innovation Center and FDA introduce ACCESS and TEMPO models to integrate digital health devices into Medicare, boosting care and payment innovation for chronic conditions.

FDA and CMS launch pilots to expand Medicare access to digital health technologies through outcome-aligned payments and regulatory flexibility, targeting chronic disease management.

Explore the complex regulatory landscape governing data exchange in value-based care, including CMS rules, HIPAA, and operational challenges affecting healthcare compliance and data governance.

CMS releases preliminary guidance for states to implement Medicaid community engagement requirements by 2027, detailing eligibility, exemptions, verification, and compliance procedures.

CMS introduces the WISeR Model in six states to optimize prior authorization using AI, aiming to reduce low-value services and Medicare costs starting 2026.

The GAO report uncovers ongoing unauthorized plan changes and enrollment fraud within the ACA marketplace, exposing verification weaknesses and highlighting the need for stronger consumer and regulatory protections.