Last Friday, the Centers for Medicare and Medicaid Services (CMS) issued a new proposed rule that would overhaul disclosure rules for health payers' pricing and cost-sharing determinations.
The 2020 Transparency in Coverage (TiC) rule required payers to disclose cost-sharing information in a machine-readable format and create...
States have until November 5 to submit applications for the Rural Health Transformation Program, a $50 billion fund for rural hospitals to support budgets and underwrite infrastructure costs. But the funding is unlikely to be enough to stave off the looming financial crisis brought on by cuts made in this year's landmark spending bill,...
On Sept. 18, 2025, a coalition of Democratic congresspeople introduced the Patients Over Profits Act, which would bar insurers and their subsidiaries from owning Medicare Part C or D providers, require divestitures of existing holdings, and prevent the Centers for Medicare and Medicaid Services (CMS) from contracting with Medicare...National News
This week, the Centers for Medicare & Medicaid Services (CMS) launched a new initiative to ensure Medicaid and Children’s Health Insurance Program enrollees meet federal citizenship and immigration requirements.
Under the policy, CMS will send states monthly reports listing individuals whose status could not be confirmed through...National News
Last Friday, the Senate Finance Committee held the confirmation hearing for Dr. Mehmet Oz, former daytime television host and President Donald Trump's pick to helm the Centers for Medicare and Medicaid Services. Oz has been publicly scrutinized for his investments and public support for the Medicare Advantage program, and sought to...National News
On January 30, the Centers for Medicare and Medicaid Services (CMS) rolled out a new website that it hopes will facilitate value-based care (VBC) uptake and education.
CMS Innovation Center Director Liz Fowler has previously noted that the parameters for "value-based care" have remained elusive to industry stakeholders. In response,...Arizona News
Hospices in Arizona and three other states are now facing a "period of enhanced oversight" from the Centers for Medicare and Medicaid Services (CMS) for new hospices, following reports of unethical or illegal business practices including "fraud, waste and abuse."
The agency will require a medical review of claims before a Medicare...National News
The Centers for Medicare and Medicaid Services (CMS) announced they would pay the 1,600 hospitals that participate in the 340B drug discount program a total of $9 billion in lump sum payments in response to the Supreme Court decision that found the program underpaid for prescription drugs. But the Medicare program also announced that it...National News
On Tuesday, the Centers for Medicare and Medicaid Services (CMS) Office of the Actuary posted projections for national health expenditures (NHE) through 2031. The report projects health spending will represent 20% of the U.S. economy and spending will surpass $7 trillion annually by 2031.
The CMS release states that the NHE and health...National News
On Monday, the U.S. Department of Health and Human Services released its Fiscal Year 2023 Budget, which focuses on investments in public health, behavioral health, health disparities, child care and advancing research. Coupled with the HHS announcement, the Centers for Medicare and Medicaid Services also released the 2021-2030 National...National News
The Centers for Medicare and Medicaid Services (CMS), along with the Biden administration, has announced a series of steps intended to help Americans sign up more easily for affordable health coverage.
The plan involves extending the open enrollment period (OEP), expanding services provided by Federally-facilitated Marketplace...Arizona News
On July 12, AHCCCS submitted a proposal to the Centers for Medicare and Medicaid Services (CMS) detailing its plan for reinvesting federal funding made available through the American Rescue Plan Act (ARPA).
The spending plan includes strategies that aim to strengthen AHCCCS’ existing home and community based services (HCBS) program...National News
The CMS proposal is getting mixed reactions from providers; some are expecting payment increases, others are anticipating losses and almost everyone is expecting the expansion of telehealth will be here to stay.
On Monday, August 3, the Centers for Medicare and Medicaid Services proposed the physician fee schedule (PFS), which...National News
CMS Administrator Seema Verma announces that value-based payment models are important to the future of the US healthcare system and that they will be flexible regarding their financial models, reporting requirements and timelines.
The CMS Center for Medicare and Medicaid Innovation (CMMI) celebrates its tenth year of driving new...CMS Rules
Accountable care organizations (ACOs) are asking for more support from the Trump administration amid the pandemic. ACOs want more time to decide on whether to voluntarily exit the Medicare Shared Savings Program (MSSP) as coronavirus-related financial losses and balance sheet deficits pile up.
With payments tied to spending and...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) finalized requirements seeking to increase access to telehealth for seniors in Medicare Advantage (MA) plans. The changes made to MA and Medicare Part D also expand supplemental benefit options for beneficiaries with chronic diseases.
CMS will grant MA plans more flexibility to...CMS Rules
Along with an increase to Medicare inpatient payment rates, a Centers for Medicare and Medicaid Services (CMS) proposed rule released on Monday is suggesting price transparency requirements that include hospitals disclosing median payer-specific rates negotiated with Medicare Advantage organizations and third-party payers.
CMS is...Arizona News
President Trump announced the formation of an independent commission last week to address the troubling number of coronavirus cases in nursing homes across the country. The Coronavirus Commission for Safety and Quality in Nursing Homes will conduct a comprehensive assessment of the nursing home response to the pandemic.
The...Arizona News
Lowering the Medicare eligibility age to 60 and forgiving student debt for low-income and middle-class individuals are two steps the now presumptive Democratic nominee for president Joe Biden has in mind to help ease the economic burden on working people.
The former Vice President took to Medium last week to unveil his plans in...Arizona News
As the novel coronavirus wreaks havoc on global economic data, risk-bearing Accountable Care Organizations (ACOs) are worried the pandemic could threaten a decade-long shift to value-based payment models. Many facilities are struggling to stay in business as a fast-approaching May 31 deadline to give notice to the Administration in...
