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Court Pauses Parts of ACA Rule

A federal court in Maryland has issued a temporary stay in the implementation of eight provisions in CMS’s Affordable Care Act marketplace rule – provisions that were to take effect on July 20. In a challenge to the legality of portions of the regulation in the case of City of Columbus v. Kennedy, the court concluded that the plaintiffs were likely to succeed in their challenge to some provisions in question even before further proceedings and therefore vacated: the expansion of eligibility for catastrophic plans through an income-based hardship exemption; [...]

July 22, 2026|Categories: Affordable Care Act|Tags: Affordable Care Act catastrophic plans, Affordable Care Act income verification requirements, Affordable Care Act marketplace rule, Affordable Care Act network adequacy requirements, Affordable Care Act out-of-pocket limits, Affordable Care Act special enrollment periods, proposed elimination of Affordable Care Act standardized plans|

CMS Touts ACO REACH Model Results

An evaluation commissioned by the Center for Medicare and Medicaid Innovation has found that the agency’s Medicare ACO REACH (Realizing Equity, Access, and Community Health) Model is saving money and improving health care outcomes. A summary of an evaluation of the program’s 2023 performance year explained that The ACO REACH Model is an advanced accountable care organization (ACO) initiative to promote patient-centered care, lower costs, and align payment systems for Original Medicare beneficiaries through ACO risk-sharing and prospective payment. In performance year (PY) 2023, the model showed stronger improvements in [...]

July 20, 2026|Categories: Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicare, Medicare reimbursement policy|Tags: Access, and Community Health Model, Center for Medicare and Medicaid Innovation, Medicare Medicare ACO REACH Model, Medicare Realizing Equity|

Federal Health Policy Update for July 16

Don’t Miss: CMS proposed 2027 physician payment regulation House Ways and Means passes health care bills DHS publishes new, final public charge rule HHS pursues delivery models for potential psychedelic drugs for behavioral health treatment The following is the latest health policy news from the federal government for July 10-16. Some of the language used below is taken directly from government documents. CMS – Proposed 2027 Medicare Physician Fee Schedule Rule CMS has published its proposed physician fee schedule rule for 2027. Highlights include: A proposed reduction in Medicare physician [...]

July 16, 2026|Categories: 340b, Accountable Care Organization, ACO, Alternative payment models, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|Tags: Accelerating Medical Treatments for Serious Mental Illness executive order, ACO Reach model, ACO Realizing Equity Access and Community Health Model, Clinical Laboratory Improvement Amendments CLIA, Clinical Laboratory Improvement Amendments CLIA request for information, cyclosporiasis, HCPCS codes, health care-associated infections, House Budget Committee, House Ways and Means Committee, Independent Dispute Resolution entities, Medicaid and children’s behavioral health care, Medicaid and CHIP Payment and Access Commission, Medicaid state directed payments, Medicaid state plan amendments, Medicare physician payment rates, MLN Connects, National Advisory Committee on Rural Health and Human Services, No Surprises Act, proposed Medicare 2027 physician fee schedule regulation, Proposed Medicare 2027 physician fee schedule rule, public charge regulation, public charge rule, Small Health Care Provider Quality Improvement Program, state nursing facility surveys|

HHS Regulatory Agenda Revealed

The federal Office of Management and Budget has posted an updated version of the administration’s 2026 unified regulatory agenda and among the items posted are more than 180 for the Department of Health Services. Among the HHS items are 44 for the Centers for Medicare & Medicaid Services, which administers the Medicare and Medicaid programs. Most of the items are proposed rules, and among the issues CMS is expected to address through regulation during the rest of 2026 are the Medicare inpatient and outpatient prospective payment systems, the Medicare physician [...]

What the Health Care Industry Wants From AI

Guidance on creating and implementing governance structures. Tools for evaluating and benchmarking potential AI tools. Coordination of AI strategy across government health care agencies. Last year, the Department of Health and Human Services issued a request for information in which it asked health care industry interests what they wanted from the federal government to facilitate their use of artificial intelligence in running their organizations and caring for their patients. Their answers? Guidance on creating and implementing governance structures. Tools for evaluating and benchmarking potential AI tools. Coordination of AI [...]

July 10, 2026|Categories: Uncategorized|Tags: AI in health care, artificial intelligence in health care, HHS request for information about AI|

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