Centers for Medicare & Medicaid Services

Federal Health Policy Update for October 9

The following is the latest health policy news from the federal government for October 3-9. Some of the language used below is taken directly from government documents. Please note that most HHS and other health care-related agencies have indicated that they will not be announcing new policies, publishing proposed regulations, or updating their web sites during the current federal government shutdown. Congress and the Shutdown Today the Senate voted on separate Democratic- and Republican-led continuing resolutions (CRs) for the seventh time but again was unable to reach the 60-vote majority needed to pass a measure. Once again, only three Democratic senators [...]

joe2025-10-09T15:13:15-04:00October 9, 2025|Centers for Medicare & Medicaid Services, Congress, Medicaid, Medicaid managed care, Medicare|

Dispute Resolution Continues Despite Shutdown

The No Surprises Act’s Independent Dispute Resolution process continues during the federal government shutdown. The Centers for Medicare & Medicaid Services has issued a notice advising disputing parties to continue submitting disputes for resolutions but warns that a prolonged shutdown could affect the timeliness of the resolution of those disputes. Learn more from this CMS notice.

joe2025-10-07T11:52:54-04:00October 7, 2025|Centers for Medicare & Medicaid Services|

Federal Health Policy Update for October 3

The following is the latest health policy news from the federal government for September 26 to October 3. Some of the language used below is taken directly from government documents. Health Care During the Government Shutdown With the federal government technically without spending authority now that FY 2026 has begun without an approved FY 2026 budget, the federal role in health care will change in some respects and be greatly reduced in others. Medicare and Medicaid will continue to function; previous legislation ensures Medicaid funding through the first quarter of FY 2026. States will continue to receive federal funding to [...]

joe2025-10-03T14:33:33-04:00October 3, 2025|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicare, Medicare reimbursement policy, Telehealth|

Health Care During the Government Shutdown

With the federal government technically without spending authority now that FY 2026 has begun without an approved FY 2026 budget, the federal role in health care will change in some respects and be greatly reduced in others. The Department of Health and Human Services anticipates reducing its workforce by 40 percent during the federal government shutdown while the Centers for Medicare & Medicaid Services anticipates furloughing nearly half its staff. The Office of Management and Budget has issued a memo encouraging agencies to consider making at least some and possibly many of these furloughs permanent. Medicare and Medicaid will continue [...]

joe2025-10-01T08:42:28-04:00October 1, 2025|Centers for Medicare & Medicaid Services, Congress, hospitals, Medicaid, Telehealth|

Hospitals to Face More Readmissions Penalties in 2026

Hospital readmissions penalties will increase, as will the size of the typical penalty, in the coming year. Beginning in FY 2026, the proportion of hospitals that will be penalized at least one percent for excessive readmissions under the Centers for Medicare & Medicaid Services’ Hospital Readmissions Reduction Program will rise from seven percent of all hospitals to eight percent. The number of hospitals penalized less than one percent will decline. Hospitals that care for the highest proportions of dually eligible Medicare/Medicaid patients will see their penalties increase slightly. The penalties levied in FY 2026 will reflect hospital performance between July [...]

joe2025-09-26T10:48:58-04:00September 30, 2025|Centers for Medicare & Medicaid Services, Medicare|

MACPAC Meets

Members of the Medicaid and CHIP Payment and Access Commission met recently in Washington, D.C. The following is MACPAC’s own summary of its two days of public meetings. MACPAC’s September 2025 meeting began with a summary of Public Law 119-21, an Act to Provide for Reconciliation Pursuant to Title II of H. Con. Res. 14 (2025 Budget Reconciliation Act, P.L. 119-21). This legislation included several provisions affecting Medicaid and the State Children’s Health Insurance Program (CHIP). In this session, staff provided a summary of the Medicaid and CHIP-related provisions in the 2025 Budget Reconciliation Act. Staff then presented on work [...]

joe2025-09-26T09:15:24-04:00September 29, 2025|Centers for Medicare & Medicaid Services, Congress, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations|

Federal Health Policy Update for September 25

The following is the latest health policy news from the federal government for September 19-25. Some of the language used below is taken directly from government documents. Federal Funding for Fiscal Year 2026 Telehealth and Acute Hospital Care at Home Program Flexibilities Many current telehealth flexibilities and authorization for the Acute Hospital Care at Home program will expire on September 30 unless Congress extends them. The following is CMS’s current guidance on these programs if they are not extended by September 30: The CMS Acute Hospital Care at Home web page advises stakeholders that The Acute Hospital Care at Home [...]

MedPAC Meets

MedPAC’s commissioners held their latest public meetings on Thursday, September 4 and Friday, September 5. The subjects on the meetings’ agenda were: Medicare payment operations and improving payment accuracy oversight needed to ensure Medicare’s sustainability: a report from the Government Accountability Office context for Medicare payment policy access to hospice and certain services under the hospice benefit for beneficiaries with end-stage renal disease or cancer the association between changes in Medicare Advantage enrollment and hospital finances Go here for summaries of the issues and key points and links to the presentations delivered by MedPAC staff and go here a transcript [...]

joe2025-09-09T13:26:12-04:00September 10, 2025|Centers for Medicare & Medicaid Services, Medicare, Medicare reimbursement policy, MedPAC|

CMS Tinkers With Models

The Centers for Medicare & Medicaid Services has announced changes in two of its Medicare accountable care models: the Achieving Healthcare Efficiency Through Accountable Design (AHEAD) Model and the Transforming Episode Accountability (TEAM) Model. The AHEAD Model is a state total cost of care model that seeks to drive state and regional health care transformation and multi-payer alignment with the goals of improving the total health of the population involved, promoting competition and choice, enhancing prevention, and empowering patients. Under the changes, states must implement at least two policies focused on promoting choice and competition in their health care markets [...]

joe2025-09-04T17:31:02-04:00September 9, 2025|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, Medicare, Medicare post-acute care, Medicare reimbursement policy|

Federal Health Policy Update for September 4

The following is the latest health policy news from the federal government for August 29 – September 4. Some of the language used below is taken directly from government documents. Congress The House and Senate have returned to Washington D.C., where their focus has turned to funding for the federal government, which expires on September 30. Senior appropriators predict that Congress will pass a continuing resolution (CR) to keep the government open through at least mid-November. We expect any CR to include a number of health care extenders for programs that also expire after September 30, including for telehealth flexibilities, [...]

joe2025-09-04T15:15:10-04:00September 4, 2025|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, Telehealth|