Centers for Medicare & Medicaid Services

Federal Health Policy Update for July 9

Don’t Miss: CMS ends fast track process for Medicaid 1115 waiver renewals HHS publishes 2026 regulatory agenda HHS asks hospitals to sign healthy foods pledge The following is the latest health policy news from the federal government for July 3-9. Some of the language used below is taken directly from government documents. Congress Congress will return to session on July 13. Committees with jurisdiction over health care will continue focusing on legislation that could ultimately be incorporated into a reconciliation package, FY 2027 appropriations legislation, or other end-of-year legislation. Centers for Medicare & Medicaid Services (CMS) In the wake of [...]

joe2026-07-09T14:47:22-04:00July 9, 2026|Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for July 2

Don’t Miss: CMS proposes CY 2027 Medicare outpatient rates, reviving 340B cuts, expanding site-neutral payments CMS calls for modest Medicare home health pay hike, more ways to oust providers Court halts borrowing limit that jeopardized supply of qualified health professionals The following is the latest health policy news from the federal government for June 25-July 2. Some of the language used below is taken directly from government documents. Proposed CY 2027 Medicare Outpatient Prospective Payment and Ambulatory Surgical Center Rule CMS has published its proposed Medicare FY 2027 outpatient and ambulatory surgical center prospective payment system rule. The proposed [...]

joe2026-07-02T16:55:39-04:00July 2, 2026|340b, Accountable Care Organization, Affordable Care Act, Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for June 25

Don’t Miss: CMS posts a new presentation on Medicaid eligibility under HR 1 House health subcommittee marks up health care price transparency bills Cassidy proposes 340B bill HRSA announces two maternity-related funding opportunities The following is the latest health policy news from the federal government for June 19-25. Some of the language used below is taken directly from government documents. Congress The House Energy and Commerce Committee’s Oversight Subcommittee held a hearing to discuss integrity and fraud risk in state Medicaid programs; witnesses included state Medicaid directors from California, Minnesota, New York, and Ohio. For more information, see the press [...]

joe2026-06-25T17:28:47-04:00June 25, 2026|340b, Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy|

MACPAC Issues Report to Congress

The Medicaid and CHIP Payment and Access Commission has sent its 2026 report to Congress. The report – mandated by Congress – includes recommendations for: overseeing community engagement/work requirements in Medicaid, including MedPAC’s recommendation that the Centers for Medicare & Medicaid Services develop a transparent plan through which it can monitor and evaluate community engagement requirements improving CMS’s oversight of the use of automation in Medicaid prior authorization decisions improving the accountability of states’ Medicaid managed care programs appropriate access to residential treatment services for Medicaid-enrolled youth with special behavioral health needs and disabilities facilitating the transition of children and [...]

joe2026-06-17T09:45:11-04:00June 17, 2026|Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations for long-term care|

Federal Health Policy Update for June 11

The following is the latest health policy news from the federal government for June 5-11. Some of the language used below is taken directly from government documents. Don’t Miss: CMS warns more than 500 hospitals for failing to meet price transparency requirements HHS OIG looks at Medicare Advantage rejections of post-acute services Federal court rejects $100,000 H-1B visa fee HHS RFI seeks new approaches, including AI, for treating addiction CMS creates new office to help with tech modernization Congress Some Republican members of Congress continue to plan for a third party-line reconciliation bill to focus on health care affordability. The [...]

joe2026-06-11T16:08:27-04:00June 11, 2026|Alternative payment models, Centers for Medicare & Medicaid Services, Congress, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

CMS Warns Hospitals About Price Transparency

The Centers for Medicare & Medicaid Services has written to more than 500 hospitals, warning them that they are failing to meet federal requirements for price transparency. The letter warns hospitals that they are at risk of fines if they do not publicly provide more and better price information. Some have been told they must submit improvement plans. CMS’s view is that the lack of price transparency prevents consumers from comparing hospitals’ prices for services. Learn more about the CMS warning and find a link to a list of the hospitals that have been warned in the AP article “Trump [...]

joe2026-06-09T17:20:07-04:00June 10, 2026|Centers for Medicare & Medicaid Services, hospitals|

Federal Health Policy Update for June 4

Don’t miss: CMS publishes new Medicaid work/community engagement requirements Energy and Commerce Committee looks at price transparency in health care An AI executive order and Congress prepares to weigh in Price cut: IDR dispute fee to fall from $115 to $15 per dispute The following is the latest health policy news from the federal government for May 29 to June 4. Some of the language used below is taken directly from government documents. Medicaid Work Requirements – Interim Final Rule CMS has published an interim final rule with comment period to implement the Medicaid work and community engagement requirements [...]

joe2026-06-04T16:30:46-04:00June 4, 2026|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, hospitals, Medicaid, Medicare|

Federal Health Policy Update for May 28

The following is the latest health policy news from the federal government for May 22-28. Some of the language used below is taken directly from government documents. Congress When Congress returns from the Memorial Day recess next week, lawmakers will have to address the Republican-led reconciliation bill to fund ICE and CBP. After, they plan to start working on a third party-line bill focusing on affordability—including health care—which leadership aims to pass by the end of July. Next week, the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies is scheduled to mark up its Fiscal [...]

sysadmin2026-05-28T17:43:32-04:00May 28, 2026|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, MACPAC, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for May 21

The following is the latest health policy news from the federal government for May 15-21. Some of the language used below is taken directly from government documents. Congress The House Ways and Means Committee marked up several health care bills addressing issues such as durable medical equipment (DME) and home health fraud. A discussion draft that would have required non-profit hospitals and health systems to provide additional reporting on community benefit spending was removed from the list of measures considered. See all the marked-up bills and a recording of the meeting on the committee’s website here. Ways & Means expects [...]

joe2026-05-21T16:10:09-04:00May 21, 2026|Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicaid, Medicaid managed care, Medicaid regulations, Medicare reimbursement policy|

A Closer Look at the Proposed Drug Prior Authorization Regulation

Last month, the Centers for Medicare & Medicaid Services proposed new requirements for the prior authorization of drugs for patients served by Medicare Advantage, Medicaid, CHIP, and qualified health plans in the federal marketplace. This proposal represented a next step to requirements CMS laid out in 2024 when it called on payers to offer electronic prior authorization for medical services and to respond to providers within required timeframes: seven days for standard requests and 72 hours for expedited requests. Now, CMS proposes requiring these payers to meet these standards through electronic prior authorization for drugs covered under their plans’ pharmacy [...]

joe2026-05-12T17:18:03-04:00May 14, 2026|Centers for Medicare & Medicaid Services, Medicaid, Medicare|