Medicare

Federal Health Policy Update for October 8

Don’t Miss: Latest 340B developments CMS penalizes majority of hospitals for failing to meet Readmissions Reduction Program standards FTC reminds hospitals of price transparency requirements The following is the latest health policy news from the federal government for October 2-8. Some of the language used below is taken directly from government documents. The White House The White House announced that the federal government will make one-time payments of $90 per person to more than 20 million Medicare enrollees – about one-third of Medicare participants – to help them pay their Medicare Part B premiums. Most eligible seniors will receive the [...]

joe2026-10-08T16:40:19-04:00October 8, 2026|340b, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, hospitals, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for September 24

Don’t Miss: CMS plans major cuts in Medicare clinical lab payments Administration reconsiders shifting NIH grant decisions to White House All states enroll in CMS model to reduce prices of selected Medicaid-covered drugs The following is the latest health policy news from the federal government for September 18-24. Some of the language used below is taken directly from government documents. The White House The White House has issued the executive order “Enhancing Program Integrity and Interagency Coordination in the Administration of the H-1B Nonimmigrant Visa Program.” The order increases federal oversight of the H-1B visa program because “The abuse of [...]

joe2026-09-24T15:28:11-04:00September 24, 2026|Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid and homelessness, Medicaid regulations, Medicare, Medicare reimbursement policy|

CMS Eyes Major Cuts in Medicare Clinical Lab Rates

Medicare payments for clinical laboratory services will soon be coming down. The Centers for Medicare & Medicaid Services is working to bring Medicare’s clinical laboratory services rates into line with those paid by commercial insurers. Asserting that Medicare is now paying 16 percent more for clinical lab tests than commercial payers, the agency has posted proposed rates for calendar year 2027 that reflect the beginning of what in some cases will be a multi-year process of aligning public and private lab payments – “aligning” by reducing Medicare payments. Hospital laboratories perform between 40 and 55 percent of laboratory tests. While [...]

joe2026-09-22T17:17:48-04:00September 23, 2026|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for August 13

Don’t Miss: Federal court vacates key aspect of No Surprises Act’s IDR process President calls for changes in childhood immunizations CMS seeks billing info so it can pay APM docs their bonuses The following is the latest health policy news from the federal government for August 7-13. Some of the language used below is taken directly from government documents. The White House The White House has issued an executive order calling for a change in recommended childhood vaccines. The order suggests reducing the number of recommended childhood vaccines from the current 17 to 11 revising the status of the remaining [...]

joe2026-08-13T14:39:23-04:00August 13, 2026|Alternative payment models, Centers for Medicare & Medicaid Services, Congress, hospitals, Medicaid, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy|

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 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|

HHS Advisory Committee Holds First Meeting

An advisory panel created by the Department of Health and Human Services to advise the agency on how to improve the financing and delivery of health care by Medicare, Medicaid, and the Children’s Health Insurance Program and through the health insurance marketplace held its first public meeting earlier this week. HHS’s Healthcare Advisory Committee, which consists of 15 members, discussed its bylaws and heard presentations from the leaders of its six workgroups. Those workgroups are: Reducing Administrative Burden MAHA by Improving Wellness and Preventing Chronic Disease Deploying Real-Time Data Improving Care for Vulnerable Populations Strengthening Medicare Advantage Crushing Fraud, Waste, [...]

joe2026-05-20T09:26:01-04:00May 22, 2026|Medicaid, Medicare|

Medicare Innovations Foster Focus on Behavioral Health

A number of recent changes in the Medicare program appear designed to make it easier for beneficiaries to pursue behavioral health assistance. Among them: A greater focus on the integration of physical and behavioral health. A greater willingness to pay for digital behavioral health interventions. The release of several requests for information addressing behavioral health services. The introduction of new behavioral health procedure and billing codes. The inclusion of behavioral health in new Medicare models, including the LEAD (Long-Term Enhanced ACO Design) Model, the ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model, and the MAHA ELEVATE (Make America Healthy [...]

joe2026-04-23T15:06:02-04:00April 27, 2026|ACO, Alternative payment models, Medicare, Medicare reimbursement policy|

“Rural Emergency Hospital” Designation Making a Difference for Some Communities

The new (since 2023) classification of some hospitals as “Rural Emergency Hospitals” is proving to be an effective tool for preserving access to care in some rural communities. The program, introduced to help stem the closure of rural hospitals, which was leaving many communities without reasonable access to care, appears to be having the desired effect. Among the benefits reported by the administrators of such hospitals – which must apply for this special federal designation – are preservation of access to emergency and outpatient services, including surgery, laboratory, imaging, and therapy, in communities where they were otherwise in jeopardy; financial [...]

joe2026-03-11T11:18:59-04:00March 12, 2026|340b, hospitals, Medicare|

Medicare Advantage Musical Chairs Continues

Even as the number of seniors enrolling in Medicare Advantage plans rises every year, the program’s stability is threatened by the withdrawal of those plans from the program. According to a new JAMA Network analysis, after years of just one percent of Medicare Advantage participants being forced to find new plans because their plan left the program, the rate of participants who need to find new plans for that reason rose to 6.5 percent in 2025 and to ten percent in 2026. This is occurring, moreover, even though the number of plans participating in Medicare Advantage continues to increase. The [...]

joe2026-02-24T14:21:56-05:00February 24, 2026|Medicare|