Bulletin Board

The Latest CMS Efforts on Prior Authorization

The Centers for Medicare & Medicaid Services continues to work tackling the challenges posed by health insurers that insist they will not pay for certain medical services unless they authorize those services beforehand. In a new blog post, CMS Administrator Mehmet Oz reviews past, current, and future agency efforts to address the challenges posed by the need to obtain prior authorization for medical services. The latest such step, he notes, is adding electronic prior authorization to the Health Tech Ecosystem. Under this approach, work groups across the spectrum of stakeholders [...]

May 11, 2026|Categories: Centers for Medicare & Medicaid Services, Medicaid, Medicare|Tags: CHIP prior authorization, Health Tech Ecosystem, Medicaid prior authorization, Medicare Advantage prior authorization, prior authorization|

Federal Health Policy Update for May 7

The following is the latest health policy news from the federal government for May 1-7. Some of the language used below is taken directly from government documents. Congress Congress hopes to pass a reconciliation package to fund Immigration and Customs Enforcement (ICE) and Customs and Border Protection before June 1; lawmakers would then turn to a potential third reconciliation measure to address health care affordability before the mid-term elections. Health care provisions in a potential third reconciliation bill could include expanded access to health savings accounts (HSAs); changes to the [...]

May 7, 2026|Categories: Centers for Medicare & Medicaid Services, Medicaid, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|Tags: 2026 National Drug Control Strategy, CDC and measles data, FDA and HALO, FDA and Harmonizing AI and Lifecycle Operations for Data, federal budget reconciliation, Health Home Core Sets, health insurance prior authorization, Health Tech Ecosystem, IgoR program, Intelligent Generator of Research program, maternity care target areas, Medicaid state plan amendments, Medicare GLP-Bridge Program, Medicare Payment Advisory Commission, Medicare prior authorization, MedPAC, MedPAC and FY 2027 proposed hospice rule, MedPAC and FY 2027 proposed inpatient psychiatric facility rule, MedPAC and proposed FY 2027 inpatient rehabilitation facility proposed rule, MedPAC and proposed FY 2027 skilled nursing facility rule, MLN Connects, Office of National Drug Control Policy, physician visas, psychiatric over-prescribing, Senate HELP Committee hearings, USCIS and physician visa review freeze|

HHS to Attack Overprescribing of Psychiatric Drugs

The Department of Health and Human Services is launching a campaign to reduce the frequency with which providers prescribe drugs for patients with behavioral health challenges. The new campaign, announced earlier this week, will seek to analyze prescribing patterns for psychiatric drugs, evaluate those that are and are not effective, and advocate greater use of alternative, non-medication-based treatments. To support this effort, HHS plans to develop new policies and promote and support more education and outreach. HHS also has issued two sets guidelines, developed by its Substance Abuse and Mental [...]

May 7, 2026|Categories: Uncategorized|Tags: Medicaid and behavioral health care, Medicare and behavioral health care, prescribing of psychiatric drugs, psychiatric overprescribing, Substance Abuse and Mental Health Services Administration|

States Continue to Work on Medicaid Eligibility Changes

With last year’s budget reconciliation bill – also known as H.R. 1 and the “Big Beautiful Bill Act” – requiring most Medicaid beneficiaries to have jobs or participate in community engagement activities beginning next year, the states continue to develop and refine the policies and practices they will need to implement and enforce the new requirements. The KFF has surveyed state Medicaid officials to identify what the states are doing and how they are doing it. Among Kaiser’s findings: Three states intend to implement the new Medicaid work requirements this [...]

May 6, 2026|Categories: Medicaid|Tags: Medicaid community engagement requirement, Medicaid eligibility requirements, Medicaid work requirement|

Federal Health Policy Update for April 30

The following is the latest health policy news from the federal government for April 24-30. Some of the language used below is taken directly from government documents. Congress Yesterday, House Republicans adopted the Senate’s budget resolution, clearing the way for the party-line reconciliation process to move into the drafting phase. The limited budget resolution for Immigration and Customs Enforcement (ICE) and U.S. Customs and Border Protection instructs the Senate Judiciary and Homeland Security committees to write legislation by May 15. Today, the House passed the Senate’s spending bill to fund [...]

April 30, 2026|Categories: Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Medicaid, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy|Tags: CAHPS, clinical laboratory fee schedule, CMS ACCESS Model, CMS GENEROUS Model, Consumer Assessment of Healthcare Providers and Systems, federal Medicaid matching funds, HCPCS codes, health care affordability hearing, HHS Office of the National Coordinator (ONC), Medicaid home and community based services, Medicaid state plan amendments, Medicare merit-based incentive payment system, Medicare Part D, MIPS, MLN Connects, OPTN, organ procurement and transplantation network, Rural Hospital Provider Assistance Program, site-neutral payments, US Preventive Services Task Force|

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