Centers for Medicare & Medicaid Services

Federal Health Policy Update for March 19

The following is the latest health policy news from the federal government for March 13-19. Some of the language used below is taken directly from government documents. The White House President Trump has issued an executive order creating a Task Force to Eliminate Fraud that “…shall, on behalf of the President, coordinate and accelerate a comprehensive national strategy to stop fraud, waste, and abuse within Federal benefit programs, including programs administered jointly with State, local, tribal, and territorial partners.” The vice president will chair the task force, the Secretary of the Department of Health and Human Services is among its [...]

joe2026-03-19T15:41:48-04:00March 19, 2026|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, hospitals, Medicaid, Medicare, Medicare reimbursement policy|

CMS Plans IDR Changes

The Independent Dispute Resolution process that is the central implementation mechanism of the No Surprises Act will soon undergo reengineering. Working with the Labor Department and the Department of the Treasury, the Centers for Medicare & Medicaid Services plans to transition the IDR process from single-use web forms into a new IDR gateway later this year. Previewing a process that it anticipates officially unveiling in the near future, CMS notes that through this new gateway, users be able to start and respond to disputes; gain access to dispute dashboards and reports associated with their organization; track dispute information, including disputes [...]

joe2026-03-17T13:55:25-04:00March 18, 2026|Centers for Medicare & Medicaid Services|

Federal Health Policy Update for March 12

The following is the latest health policy news from the federal government for March 6-12. Some of the language used below is taken directly from government documents. Congress While the House was in recess this week, the Republican caucus held its annual retreat to discuss legislative priorities. Speaker Mike Johnson (R-LA) continues to push for another reconciliation bill, hoping to revisit several proposals to reduce Medicaid spending that were not included in HR another rank-and-file Republicans have expressed doubt that this will be possible. Both chambers of Congress are scheduled to be in session next week. The House Committee on [...]

joe2026-03-12T16:09:44-04:00March 12, 2026|Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicare, Medicare post-acute care, Medicare reimbursement policy|

CMS Will Continue Rolling Out Mandatory Models

The Centers for Medicare & Medicaid Services and its Center for Medicare and Medicaid Innovation intend to continue developing and introducing mandatory Medicare models with an emphasis on driving more value-based care. That is the message delivered by CMS administrator Mehmet Oz and CMMI director Abe Sutton during a recent conference. While the track record of CMMI’s models – both voluntary and mandatory – is not great, policymakers believe they remain the best way for government to continue encouraging health care providers to focus more on the delivery of value-based care. To date, only four of the agency’s approximately 50 [...]

joe2026-03-05T17:04:15-05:00March 10, 2026|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicare|

Federal Health Policy Update for March 5

The following is the latest health policy news from the federal government for February 27-March 6. Some of the language used below is taken directly from government documents. Congress On Thursday, the House Energy and Commerce Committee held a full committee markup of nine bills addressing cybersecurity and digital safety. See that list here. Also on Thursday, the Senate HELP Committee conducted a hearing titled “Transforming Health Care with Data: Improving Patient Outcomes Through Next-Generation Care.” Find video of the hearing here. Speaker Mike Johnson (R-LA) expressed interest in passing another reconciliation bill this year that would include policies addressing [...]

sysadmin2026-03-06T15:58:46-05:00March 6, 2026|ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicaid, Medicaid regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for February 26

The following is the latest health policy news from the federal government for February 20-26. Some of the language used below is taken directly from government documents. Congress Both chambers of Congress are in session this week and next. The partial shutdown of the Department of Homeland Security that began on February 23 continues. The House Ways and Means Committee held a hearing titled “Advancing the Next Generation of America’s Health Care Workforce” to examine the shortage of resident physicians and explore ways to strengthen rural health care providers and Graduate Medical Education (GME). Watch the hearing and review the witness testimony here. Centers for Medicare & [...]

joe2026-02-26T15:43:01-05:00February 26, 2026|340b, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for February 19

The following is the latest health policy news from the federal government for February 13-19. Some of the language used below is taken directly from government documents. Congress Congress is not in session this week and will return on Monday, February 23. The House Ways and Means Committee will hold a hearing titled “Next Generation of Health Care Workforce” on Tuesday, February 24. View a livestream of the hearing here. The Courts A federal court has vacated the Federal Trade Commission’s (FTC) 2024 overhaul of the Hart-Scott-Rodino Premerger Notification Rule. That rule expanded disclosure requirements, requiring filings for transactions valued [...]

joe2026-02-19T15:40:16-05:00February 19, 2026|340b, Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicaid, Medicare, Medicare regulations|

Federal Health Policy Update for February 12

The following is the latest health policy news from the federal government for February 6-12. Some of the language used below is taken directly from government documents. The White House The White House announced the launch of TrumpRx, a service that will enable consumers to purchase a limited number of discounted prescription drugs directly from the manufacturers of those drugs and in some cases from pharmacies without the benefit of health or prescription drug insurance. Learn more about TrumpRx and its launch from this White House announcement, an accompanying fact sheet, and the TrumpRx web site. Congress Following passage of [...]

joe2026-02-12T16:12:39-05:00February 12, 2026|340b, Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, hospitals, Medicaid, Medicare, Medicare reimbursement policy|

CMS Proposes Major Changes in Exchange Plans

The Centers for Medicare & Medicaid Services has proposed sweeping changes in the health plans offered by Affordable Care Act marketplace exchanges. The changes, revealed in CMS’s proposed Notice of Benefit and Payment Parameters for 2027, affect both the regulations governing the types of health plans that can be offered on exchanges and how potential buyers of those plans are deemed eligible for those plans. The major changes include: Permitting insurers to offer catastrophic plans with terms of either one year or multiple consecutive years, up to ten years. Repealing standardized plan options and related limit requirements. Permitting low-deductible plans [...]

joe2026-02-11T12:46:23-05:00February 12, 2026|Affordable Care Act, Centers for Medicare & Medicaid Services|

Federal Health Policy Update for February 5

The following is the latest health policy news from the federal government for January 30 through February 5. Some of the language used below is taken directly from government documents. Congress On Tuesday Congress passed, and the president immediately signed, a package of appropriations bills that, among other government operations, funded the Department of Health and Human Services for the rest of federal FY 2026. Major provisions include: The extension of telehealth flexibilities through the end of 2027. The elimination of $8 billion cuts in Medicaid disproportionate share (Medicaid DSH) allotments to the states for both FY 2026 and FY [...]