President Donald Trump has struck a deal with Pfizer in his first step towards establishing TrumpRx, a discount drug website operated by the federal government. The agreement arrives in tandem with the announcement of a new drug pricing pilot from...
Last Thursday, the Centers for Medicare and Medicaid Services (CMS) issued a final rule requiring Medicare Advantage insurers submit their provider directories to the agency for incorporation into the Medicare Plan Finder Portal.
CMS announced a plan last month to assemble provider lists and add them to the plan finder ahead of the...
In lieu of extending the Affordable Care Act (ACA) enhanced premium tax credits, the Trump administration is boosting access to catastrophic plans.
Catastrophic plans cover preventative care but carry very high deductibles. Historically, they've only been available for people under 30 who don't otherwise qualify for subsidies, but the...CMS Rules
The Centers for Medicare and Medicaid Services issued final rules for the hospice payment rate, the Medicare inpatient psychiatric facility prospective payment system (IPF PPS), and related quality reporting programs for fiscal year (FY) 2026.
CMS will update the IPF PPS payment rate by 2.5%, based on the 2021 market basket increase...CMS Rules
Late last week, the Centers for Medicare and Medicaid Services (CMS) issued the final rule for the Medicare inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS), and the final rule for skilled nursing facilities (SNF) for fiscal year (FY) 2026.
CMS pays hospitals for inpatient...CMS Rules
Last week, a coalition of Democratic-led states filed suit against the Trump administration's Centers for Medicare and Medicaid Services (CMS), in response to a final rule issued by the agency. The rule adds acute regulations to the Affordable Care Act (ACA) marketplace, which the plaintiffs allege will cause the number of uninsured...CMS Rules
This week, the Centers for Medicare and Medicaid Services (CMS) published its 2026 Outpatient Prospective Payment System (OPPS) proposed rule which would raise reimbursement for hospitals and ambulatory surgical centers (ASCs) by 2.4%. The proposal also puts forward a site-neutral policy, which would allow CMS to reimburse at the same...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) proposed the first pay boost for physicians in five years in its proposed 2026 Physician Fee Schedule (PFS). The proposed rule also contains means to curb spending and introduces billing codes for behavioral health and chronic disease.
Physicians groups have warned for the past five...CMS Rules
On Monday, the Centers for Medicare and Medicaid Services (CMS) published the proposed home health prospective payment system rule for 2026, which would substantially cut Medicare payments to home health agencies.
The prospective payment system update calls for a 6.4% cut to home health payments in 2026, or roughly $1.135 billion....
The Centers for Medicare and Medicaid Services (CMS) has temporarily finalized several pieces of a health exchange program integrity rule through 2026, including changes to the enrollment process and shortening the sign-up period; expected savings: $12B in 2026.
The changes to the Affordable Care Act (ACA) health exchange reflect the...
In tandem with an announcement that Part B drugs would be added to the Medicare Prescription Drug Price Negotiation Program, President Donald Trump announced that he would take steps to aggressively negotiate lowering all drug prices, though the means by which this would happen remains unclear.
On Monday, the administration issued...CMS Rules
The Centers for Medicare and Medicaid Services issued a proposed rule for the Medicare inpatient prospective payment system (IPPS) for fiscal year (FY) 2026. The rule includes a proposed pay bump of 2.4% for hospitals.
CMS said that the rate reflects a 3.2% projected hospital market basket increase with a 0.8% productivity adjustment...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) has proposed a rule under the Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) and the IRF Quality Reporting Program (QRP) for Fiscal Year (FY) 2026.
The agency proposes updating the payment rates by 2.6% based on the IRF market basket update of 3.4%, minus...CMS Rules
The Centers for Medicare and Medicaid Services announced its proposed Hospice Wage Index and Payment Rate Update proposed rule for FY 2026.
The proposed reimbursement update will raise the base payment rate by 2.4%, lower than the 2025 increase of 2.9%. The increase represents $695 million rise in total hospital payments, Hospice News...CMS Rules
The skilled nursing industry was elated by the Centers for Medicare and Medicaid Services (CMS) proposed Skilled Nursing Facility Prospective Payment System (SNF PPS) proposed rule, which included a 2.8% pay bump for FY 2026 and some other breaks that could reduce SNF costs.
The rate hike falls far short of the 4.2% raise that SNFs...
The Centers for Medicare and Medicaid Services (CMS) issued a final Medicare Advantage technical rule that removes regulations for the use of artificial intelligence but maintains a Biden-era provision that restricts plans from modifying approved hospital decisions, and raises MA funding by 5%.
The rule also removed proposals for...
On Monday, a federal judge in Texas ruled that the federal rule requiring nursing home staffing minimums was unconstitutional, sending sighs of relief throughout the long-term care sector.
The rule, rolled out by former President Joe Biden's administration last year, would have required nursing homes to maintain a registered nurse on...
The federal government's assault on LGBTQ people and their access to healthcare services continued this week as the Trump administration ignores an injunction, the Supreme Court accepts a case on conversion therapy and researchers sue over the removal of articles from a government website.
Beginning on day one of his second term,...CMS Rules
Last week, President Donald Trump issued an executive order aimed at the Departments of Health and Human Services (HHS), Treasury and Labor that would create an enforcement mechanism for the 2019 executive order on hospital price transparency.
The executive order modifies the demands of the original 2019 directive, including an...CMS Rules
A new rule published in the Federal Register ends public comment on the Department of Health and Human Services' (HHS) policies for benefits, contracts and grants within the agency. The rule could severely impair public transparency into policymaking at the agency.
HHS will instead comply with the Administrative Procedures Act of 1946...
