Trump administration's new health data sharing initiative involves major tech companies to improve patient access to health records, focusing on interoperability, AI-driven tools, and data privacy concerns.
Senators introduce bipartisan bill targeting Medicare Advantage overpayments by refining risk adjustment and supporting CMS audits to enhance program integrity and save Medicare billions.
CMS's price-substitution policy has saved $76 million for Medicare by correcting drug pricing identified by the Office of Inspector General, improving cost efficiency while maintaining access.
New federal rules and tax law changes reduce subsidies and tighten enrollment in ACA marketplaces, risking higher premiums and lower enrollment, especially among lawfully present immigrants. States challenge these barriers.
CMS's 2026 Physician Fee Schedule proposal advances Medicare telehealth with expanded behavioral health codes, remote monitoring updates, and virtual Diabetes Prevention Program delivery, shaping long-term digital care integration.
CMS offers a range of Medicare Learning Network web-based training courses for providers covering billing, coding, fraud prevention, and compliance. Courses are self-paced but do not provide continuing education credits. Subscribe to MLN Connects® for updates.
CMS releases 2026 Medicare payment reforms focusing on site-neutral payments, alongside Medicaid financing reforms in the One Big Beautiful Bill and updates on Part D bids influenced by the Inflation Reduction Act.
CMS introduces the WISeR Model pilot program leveraging AI-driven prior authorization to reduce Medicare overuse and fraud in six states from 2026-2031.
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.
