CMS issues proposed 2027 rules updating Medicare Advantage and Part D programs, implementing Inflation Reduction Act changes, revising star ratings, marketing oversight, and program integrity requirements.
CMS's mandatory TEAM model starts in 2026, bundling payments for select procedures and increasing home health utilization. Key insights on risks, preparation, and hospital partnerships for providers.
United Healthcare will discontinue Medicare Advantage plans in Sanders County starting January 2026, requiring affected members to find alternative coverage. Clark Fork Valley Hospital retains its United Healthcare contracts amid the insurer's market exit.
CMS proposes Medicare coverage for federally and state-legal CBD products, highlighting evolving regulatory approaches amid clinical evidence and hemp legislation conflicts.
CMS delays skilled nursing facilities' mandatory ownership revalidation indefinitely due to system issues, maintaining transparency rules amid compliance challenges.
The new WISeR Medicare pilot uses AI to manage prior authorizations, impacting care access and insurer incentives in six states, with significant implications for rural healthcare.
ASCRS addresses 2025 Medicare cuts, CMS proposals impacting cataract surgery reimbursement, scope of practice expansions, and advocates for fair payment and regulatory reforms in ophthalmology for 2026.
The Fifth Circuit Court ruled Texas hospitals must complete Medicare's administrative appeal process before filing lawsuits over payment disputes, reversing a lower court decision on HHS payment restrictions.
Medicare Advantage plans are leaving Vermont next year, affecting 50,000 enrollees who must find alternative coverage by year-end due to federal policy changes.
New study analyzes Medicaid enrollment trends among U.S. nursing home residents, highlighting financial burdens, racial disparities, and implications for Medicaid sustainability in long-term care financing.
