Timeline — Policy / Regulatory Changes
Signals in this topic on one timeline — one payer bubble row apiece, all in this topic's color.
67 signals in the last 30 days
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8 recent Medicare Advantage contract suspensions, terminations
CMS has taken a series of enforcement actions against Medicare Advantage plans over the last two years, suspending enrollment and terminating contracts over issues ranging from network adequacy to financial solvency failures. Eight updates: The post 8 recent Medicare Advantage contract suspensions, terminations appeared first on Becker's Payer Issues | Payer News .
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Medicare paid estimated $380M for unused organs: OIG
Over a six-year period, Medicare may have spent $380 million on organs that were not ultimately used in covered enrollee transplants, according to a September HHS Office of Inspector General report. Under federal law, Medicare can only reimburse certified transplant centers for organs used in covered transplants. However, CMS guidance relies on the assumption that […] The post Medicare paid estimated $380M for unused organs: OIG appeared first on Becker's Payer Issues | Payer News .
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CMS rebrands ICHRA
CMS has rebranded individual coverage health reimbursement arrangements to CHOICE Arrangements, or Custom Health Option and Individual Care Expense. The new name for the alternative health insurance model was announced Sept. 3 by CMS Administrator Mehmet Oz, MD, at an event in Indiana. ICHRAs let employers give workers a fixed, tax-free amount to buy their […] The post CMS rebrands ICHRA appeared first on Becker's Payer Issues | Payer News .
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OIG: Medicare Part D plans spent millions on ineligible OTC drugs
Medicare Part D plans made millions in payments for drugs that were ineligible under the program, according to a new federal audit.
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Federal watchdog claims Medicare Part D sponsors paid $587.7M for over-the-counter drugs mislabeled as prescription-only
Medicare Part D sponsors paid pharmacies $587.7 million for some over-the-counter drugs with obsolete prescription-only labels, despite CMS oversight. Medicare Part D does not cover OTC drugs. According to an Aug. 31 HHS Office of Inspector General report, Part D sponsors made “ineligible” payments for five drugs — more than one year after the brand-name […] The post Federal watchdog claims Medicare Part D sponsors paid $587.7M for over-the-counter drugs mislabeled as prescription-only appear...
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Medicare spent hundreds of millions of dollars on ineligible drugs, audit finds
Shoddy CMS oversight is to blame, and the agency needs to do better, the HHS Office of the Inspector General said. The CMS concurred.
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Hospital groups rail against CMS' proposed 340B changes, site-neutral payments
Public comments for the latest OPPS proposed rule saw several major hospital groups all but threatening a court showdown over CMS' planned policy changes.
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Agency Information Collection Activities: Proposed Collection; Comment Request
The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' intention to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information (including each proposed extension or reinstatement of an existing collection of information) and to allow 60 days for public comment on the proposed action. Int...
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PUBLIC COMMENT — Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems, etc, CMS-1850-P, RIN 0938-AV83
The post PUBLIC COMMENT — Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems, etc, CMS-1850-P, RIN 0938-AV83 appeared first on Paragon Health Institute .
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DOJ steps up crackdown on Medicare Advantage upcoding
The Justice Department’s scrutiny of Medicare Advantage risk adjustment is intensifying, with two recent settlements totaling nearly $1.1 billion highlighting federal concerns about diagnosis coding practices that can increase payments to health plans. The latest came Aug. 27, when The Villages (Fla.) Health System agreed to pay $541.5 million to resolve allegations that it violated […] The post DOJ steps up crackdown on Medicare Advantage upcoding appeared first on Becker's Payer Issues | Pa...
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Trump admin blocks over $1.6B in potentially fraudulent Medicare lab payments: CMS
The CMS Fraud Defense Operations Center has also accounted for more than $371 million in Medicare suspended payments involving 267 providers and suppliers since Jan. 1, the agency said.
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CMS Prevents $1.6 Billion in Fraudulent Medicare Laboratory Payments
CMS Prevents $1.6 Billion in Fraudulent Medicare Laboratory Payments 157 fraudulent lab providers revoked from Medicare program Centers for Medicare & Medicaid Services (CMS) enforcement actions have stopped more than $1.6 billion in potentially improper Medicare laboratory payments since the start of the Trump Administration – further evidence that CMS’ efforts to crush fraud are working to protect taxpayer dollars and improve Medicare program integrity. This includes $732 million in savings...
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CMS touts blocking $1.6B in potentially fraudulent Medicare payments
CMS said its enforcement efforts have resulted in blocking more than $1.6 billion in possibly improper Medicare lab payments throughout President Trump’s administration. An Aug. 28 CMS news release said these enforcement actions included savings of $732 million from 157 providers with revoked Medicare privileges, and a CMS investigation of 600 labs that resulted in 185 payment […] The post CMS touts blocking $1.6B in potentially fraudulent Medicare payments appeared first on Becker's Payer Is...
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Massachusetts Medicare Advantage insurer hit with enrollment freeze again
CMS has again suspended enrollment for two Medicare Advantage prescription drug plans offered by Boston-based EternalHealth, the second time in less than two years that the insurer has faced sanctions. The agency said Aug. 27 the enrollment freeze on the two plans is based on its determination that EternalHealth’s conduct “poses a serious threat to […] The post Massachusetts Medicare Advantage insurer hit with enrollment freeze again appeared first on Becker's Payer Issues | Payer News .
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Federal court denies Elevance’s bid for emergency 2026 star ratings recalculation
A federal judge has denied Elevance Health’s request for an emergency recalculation of its 2026 Medicare Advantage star ratings. On Aug. 27, U.S. District Judge Lisa Godbey Wood ruled that Elevance waited too long to file for the emergency recalculation and failed to show that an injunction would prevent alleged competitive harm. In the same […] The post Federal court denies Elevance’s bid for emergency 2026 star ratings recalculation appeared first on Becker's Payer Issues | Payer News .
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The Villages Health reaches $541M False Claims Act settlement with DOJ
The Villages Health System has agreed to a $541.5 million settlement to resolve allegations that it submitted false diagnosis codes to secure higher payouts in Medicare Advantage.
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STAT+: CMS plans launch event for ACCESS, the Medicare chronic care pilot
In this edition of STAT Health Tech: CMS plans a launch event for Medicare chronic care pilot, and what the Meta settlement means for health AI.
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$10M from Florida’s Centene Medicaid settlement misappropriated by DeSantis administration: Report
A state grand jury determined that $10 million from a Centene Medicaid settlement was “misappropriated” under Florida Republican Gov. Ron DeSantis’ administration, according to a Jan. 28 sealed document obtained by CBS News Miami. Despite the findings, the document said the grand jury lacked evidence to bring criminal charges. The settlement stemmed from claims of […] The post $10M from Florida’s Centene Medicaid settlement misappropriated by DeSantis administration: Report appeared first on...
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Villages Health to pay $541.5M to settle Medicare Advantage fraud allegations
The Villages (Fla.) Health, a primary and specialty care provider group, has agreed to pay $541.5 million to resolve allegations that it violated the False Claims Act by submitting improper Medicare Advantage diagnosis codes, according to an Aug. 26 news release from the Justice Department. TVH, which sought Chapter 11 bankruptcy protection in July 2025 […] The post Villages Health to pay $541.5M to settle Medicare Advantage fraud allegations appeared first on Becker's Payer Issues | Payer Ne...
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CMS releases fact sheet, FAQs on 340B claims data repository
The Centers for Medicare & Medicaid Services has released a fact sheet and FAQs on the 340B Part D claims data repository that will go live Oct. 1. Data submissions would currently be voluntary for 340B hospitals. However, the agency recently proposed to make data submissions mandatory starting in 2027. The fact sheet and FAQ provide an overview of the repository along with other key details.
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Humana-owned Villages Health agrees to $542M settlement for overbilling Medicare
The Central Florida provider manufactured fake diagnosis codes for its Medicare Advantage patients from 2020 to 2024, the DOJ said. Humana bought The Villages Health last year.
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Agency Information Collection Activities: Proposed Collection; Comment Request
The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' intention to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information (including each proposed extension or reinstatement of an existing collection of information) and to allow 60 days for public comment on the proposed action. Int...
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Monogram Health to pay $2.4M to settle Medicare Advantage upcoding allegations
The Justice Department told Healthcare Dive that Monogram, a home health company, overcharged Medicare through contracts with Cigna and Humana by inflating diagnostic codes.
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Elevance Health to pay $15M to settle nurse overtime lawsuits
A federal judge has given final approval to a $14.75 million settlement between Elevance Health and a group of nurses who alleged the insurer misclassified them as exempt from overtime pay. U.S. District Judge David Novak signed off on the deal Aug. 20 in the Eastern District of Virginia, closing out five related lawsuits that […] The post Elevance Health to pay $15M to settle nurse overtime lawsuits appeared first on Becker's Payer Issues | Payer News .
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Medicare Advantage provider agrees to $2.4M false claims settlement
Tennessee-based in-home care provider Monogram Health has agreed to pay $2.4 million to settle allegations that it caused the submission of false diagnosis codes to boost Medicare Advantage payments. From Jan. 1, 2021, through Dec. 31, 2023, Monogram allegedly knowingly submitted diagnosis codes that were not clinically accurate, not supported by patients’ medical records, or […] The post Medicare Advantage provider agrees to $2.4M false claims settlement appeared first on Becker's Payer Issu...
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Oregon to launch state-based ACA exchange
Oregon has received approval from CMS to launch a state-run ACA marketplace starting Nov. 1. The new platform, Explore Health, will let Oregon residents shop for ACA plans, check subsidy eligibility and enroll in coverage directly through the state rather than the federal exchange. The Oregon legislature authorized the transition in 2023 through Senate Bill […] The post Oregon to launch state-based ACA exchange appeared first on Becker's Payer Issues | Payer News .
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Oz says MMR vaccine 'is not a lethal vaccine'
Dr. Mehmet Oz, the administrator of the Centers for Medicare and Medicaid Services (CMS), noted Sunday the measles, mumps and rubella (MMR) vaccine is not lethal, contradicting President Trump. “The MMR vaccine is not a lethal vaccine, and it is offered in other countries,” Oz told host Margaret Brennan on CBS News’s “Face the Nation.”...
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Agency Information Collection Activities: Proposed Collection; Comment Request
The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' intention to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information (including each proposed extension or reinstatement of an existing collection of information) and to allow 60 days for public comment on the proposed action. Int...
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Senate Democrats call on feds to halt Medicaid data sharing with ICE
Senate Democrats on Aug. 17 called on federal officials to end Medicaid enrollee data sharing with the Department of Homeland Security and Immigration and Customs Enforcement. Sens. Ron Wyden, D-Ore., Jeff Merkley, D-Ore., Edward Markey, D-Mass., Cory Booker, D-N.J., and Chris Van Hollen, D-Md., sent two letters, one to CMS and HHS and another to […] The post Senate Democrats call on feds to halt Medicaid data sharing with ICE appeared first on Becker's Payer Issues | Payer News .
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Privacy Act of 1974; System of Records
In accordance with the Privacy Act of 1974, as amended, the Department of Health and Human Services (HHS) is establishing a new system of records to be maintained by the Centers for Medicare & Medicaid Services (CMS), titled "Nurses for Nursing Homes Program (NNHP)," system No. 09-70-0545. The new system of records will cover the collection of records on individuals who apply for, participate in, or otherwise support the Nurses for Nursing Homes Program (NNHP). Records maintained in the syste...
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CMS News: Trump Administration Announces $35 million to Support Investments in Rapid Response Capabilities to Improve Rural Pennsylvania Healthcare
Trump Administration Announces $35 million to Support Investments in Rapid Response Capabilities to Improve Rural Pennsylvania Healthcare Federal investment will help provide technology, equipment and expanded transportation options for communities across Pennsylvania The Trump Administration announced that $35 million, made possible through the federal Rural Health Transformation Program (RHTP), is being put to work to improve health outcomes among rural Pennsylvanians by updating to new, mo...
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‘No-brainer’: PBMs commit to posting TrumpRx price comparisons
The Pharmaceutical Care Management Association and its members committed to sharing TrumpRx’s cash prices for drugs through their real-time benefit tools and other cost transparency platforms. An Aug. 13 news release said the association coordinated with the Trump administration and CMS Administrator Mehmet Oz, MD, on the effort. PCMA members include Elevance Health’s CarelonRx, CVS […] The post ‘No-brainer’: PBMs commit to posting TrumpRx price comparisons appeared first on Becker's Payer Is...
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AMA applauds updated CMS prior authorization reporting guidance
The organization said the agency responded to its concerns about payers' implementation of the transparency provisions of the 2024 final rule.
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CommonSpirit’s 5 targets for judging payer prior auth reform — and its Humana milestone
In 2025, insurers committed to scaling back and simplifying prior authorization as they fall into line with standards established by the 2024 Interoperability and Prior Authorization and Medicare Advantage final rules. But recent aggregated data on prior authorization — which insurers now have to report, thanks to the 2024 regulation — lacks relevant context. For […] The post CommonSpirit’s 5 targets for judging payer prior auth reform — and its Humana milestone appeared first on Becker's Pay...
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CMS announces QualTech event focusing on innovative technology to improve health outcomes
The Centers for Medicare & Medicaid Services yesterday announced the launch of QualTech, a new event created to identify innovative technology that improves health outcomes. CMS is seeking participants from U.S-based teams, academic institutions, nonprofit organizations, private sector companies, industry associations and other stakeholders to propose technology solutions in advance of the event. Applicants must align proposal submissions to one of four priority opportunity areas: using artif...
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America digitized healthcare. Now it’s time to connect it.
Seema Verma, a former administrator for the CMS, makes the case for better connecting healthcare data as the agency marks the first anniversary of its “Kill the Clipboard” initiative.
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Medi-Cal plans brace for ‘devastating’ asset limit crunch
California’s Medicaid program, Medi-Cal, is slashing asset limits 84% in July 2027. As a result, Medi-Cal members risk losing eligibility — and insurers are feeling the pressure. In 2022, California lifted the asset limit from $2,000 to $130,000 for individuals. CMS eventually approved a state proposal to drop the asset test, but California resurfaced the […] The post Medi-Cal plans brace for ‘devastating’ asset limit crunch appeared first on Becker's Payer Issues | Payer News .
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AHA comments on CMS proposal to codify Medicare Drug Price Negotiation Program regulations
The AHA Aug. 17 provided comments to the Centers for Medicare & Medicaid Services on its proposed rule to codify in regulation the Medicare Drug Price Negotiation Program. The AHA recommended CMS require drug manufacturers to make the maximum fair price available through a point-of-sale mechanism and eliminate any option permitting manufacturers to meet their obligations through retrospective rebates or post-sale reconciliations. The AHA expressed concerns that permitting retrospective MFP ef...
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Medicare Advantage has always demanded accuracy. What’s changed is the level of scrutiny.
The Medicare Advantage (MA) landscape is entering a new chapter. For the first 25 years of the program, success was largely measured by how effectively organizations captured and supported HCCs while maintaining coding accuracy. That objective hasn’t changed. What has changed is the scorecard. As CMS expands RADV across all Medicare Advantage contracts, implements CMS-HCC […] The post Medicare Advantage has always demanded accuracy. What’s changed is the level of scrutiny. appeared first on B...
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Why the first 24 hours after discharge matter for star ratings
Why leading Medicare Advantage plans are rethinking care transitions.
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Why CMS’ Medicaid waiver pullback matters to providers
CMS risks raising costs for states, weakening provider finances and limiting Medicaid innovation as it curbs 1115 waivers.
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Industry Voices—AI should help cancer patients survive the healthcare system
Cancer care navigators are an invaluable resource, but there are nowhere near enough navigators to meet the scale of the need. This is where AI can make a meaningful difference, write the Digital Medicine Society's Jennifer Goldsack and former CMS Chief Medical Officer Lee Fleisher, M.D.
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Hippocratic AI rolls out platform to coordinate teams of conversational voice AI agents
For health plans, the AI teams support functions such as member onboarding, chronic care management and Star Ratings improvement. Provider-focused offerings target patient onboarding, care gap closure and inpatient and ambulatory workflows.
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‘Private option’ Medicaid expansion under threat from CMS
Arkansas Medicaid coverage for hundreds of thousands is uncertain next year after the Trump administration denied a key waiver renewal.
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Prior authorization denials vary widely among insurers, first-of-its-kind data shows
Denials ranged from 2% to 25% among insurers last year, according to a KFF analysis of new prior authorization data that the CMS forced insurers to release.
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How will legal challenges fare against CMS rule on gender-affirming care?
A CMS rule finalized this week may prove more difficult to challenge than previous Trump administration actions to end transgender care for young people.
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Where prior authorization stands — and where data still falls short
Prior authorization data is now public — but it is not giving much to work with. CMS’ Interoperability and Prior Authorization Final Rule from 2024 focused on easing prior authorization across government-affiliated healthcare programs. Involved payers now have to report certain aggregated metrics, such as approval and denial rates. Data covering 2025 went live March […] The post Where prior authorization stands — and where data still falls short appeared first on Becker's Payer Issues | Payer...
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Payers ranked by prior authorization denial rates
Health insurers denied between 12% and 18% of standard prior authorization requests across Medicare Advantage, Medicaid managed care and ACA marketplace plans in 2025, with wide variation among the largest payers, according to a KFF analysis published Aug. 13. CMS previously finalized a rule requiring certain insurers to publicly report prior auth metrics, including denial […] The post Payers ranked by prior authorization denial rates appeared first on Becker's Payer Issues | Payer News .
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Glenmark’s US subsidiary reaches $15.3M settlement with Humana
The U.S. subsidiary of Glenmark Pharmaceuticals will pay Humana nearly $15.3 million in the wake of antitrust and consumer protection lawsuits. Glenmark disclosed the settlement in an Aug. 11 filing with the National Stock Exchange of India. The document said the company faced allegations of price-fixing, market allocation and anticompetitive behavior in more than 35 […] The post Glenmark’s US subsidiary reaches $15.3M settlement with Humana appeared first on Becker's Payer Issues | Payer News .
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Almost All Custodial Parents, Caretaker Relatives Should Not be Impacted by Medicaid Work Reporting Requirements in 28 States
As states rush to implement complex new work reporting requirement provisions before January 2027, the new Interim Final Rule (IFR) released by the Centers for Medicare and Medicaid Services (CMS) has caused massive confusion. However, the IFR made important clarifications about which adults are not subject to work reporting requirements (WRRs), are excluded from WRRs, […]
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Medicaid Program; Prohibition on Federal Medicaid and Children's Health Insurance Program Funding for Sex-Rejecting Procedures Furnished to Children
This final rule requires that a State Medicaid plan must provide that the Medicaid agency will not make payment under the plan for sex-rejecting procedures for children under 18, and prohibits the use of Federal Medicaid dollars to fund sex-rejecting procedures for individuals under the age of 18. In addition, this final rule requires that a separate State Children's Health Insurance Program (CHIP) plan must provide that the CHIP agency will not make payment under the plan for sex-rejecting p...
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Medicare Program; Alternative Payment Model (APM) Incentive Payment Advisory for Clinicians-Request for Current Billing Information for Qualifying APM Participants
This advisory is to alert certain clinicians who are Qualifying Alternative Payment Model (APM) participants (QPs) and eligible to receive an APM Incentive Payment that the Centers for Medicare & Medicaid Services (CMS) does not have the current billing information needed to disburse the payment. This advisory provides information to these clinicians on how to update their billing information to receive this payment for the 2026 payment year.
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CMS finalizes ban on Medicaid, CHIP funding for gender-affirming care provided to children
The Centers for Medicare & Medicaid Services yesterday released a final rule that prohibits states from receiving federal matching funds for “sex-rejecting procedures” for Medicaid beneficiaries under the age of 18, and for Children’s Health Insurance Program beneficiaries in certain states under the age of 19. The final rule does not prevent states from providing coverage for these services with state-only funds. CMS said that federal Medicaid and CHIP funding will be available for a taperin...
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Oscar flags up to 300K ACA disenrollments tied to CMS fraud crackdown
Oscar Health expects between 250,000 and 300,000 of its marketplace members to be retroactively disenrolled in connection with CMS program integrity initiatives and fraud, waste and abuse enforcement, the insurer disclosed Aug. 7. The expected disenrollments represent roughly 8% to 10% of Oscar’s total membership, which stood at approximately 2.96 million as of June 30. […] The post Oscar flags up to 300K ACA disenrollments tied to CMS fraud crackdown appeared first on Becker's Payer Issues |...
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CMS requests updated billing information from qualifying alternative payment model participants to disburse payment
The Centers for Medicare & Medicaid Services today released an advisory for certain clinicians who are qualifying alternative payment model participants and eligible to receive APM incentive payments, notifying them that their current billing information must be updated to receive funds for the 2026 payment year. CMS said that it was unable to identify a taxpayer identification number associated with some participants after processing 2026 APM incentive payments and therefore was unable to di...
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Trump administration cuts Medicaid funding for youth gender-affirming care
CMS Administrator Dr. Mehmet Oz argues the rule will protect children from "irreversible harm." LGBTQ+ advocates say the rule is an attack on transgender youth.
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Agency Information Collection Activities: Proposed Collection; Comment Request
The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' intention to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information (including each proposed extension or reinstatement of an existing collection of information) and to allow 60 days for public comment on the proposed action. Int...
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CMS ends Medicaid, CHIP funding for gender-affirming care for minors
The Trump administration has finalized a rule that would pull funding for gender-affirming care for minors from Medicaid and the Children's Health Insurance Program.
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Trump administration finalizes rule restricting trans healthcare for minors on Medicaid
The Trump administration on Tuesday released a final rule blocking the use of federal Medicaid dollars for transgender healthcare for minors, as well as barring Children’s Health Insurance Program (CHIP) plans from paying for gender-affirming procedures for minors. The final rule released by The Centers for Medicare and Medicaid Services (CMS) bars Medicaid dollars from...
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CMS Ends Federal Medicaid and CHIP Funding for Sex-Rejecting Procedures for Children and Youth
CMS Ends Federal Medicaid and CHIP Funding for Sex-Rejecting Procedures for Children and Youth The Centers for Medicare & Medicaid Services (CMS) is implementing an administration priority consistent with its commitment to protect children from experimental and life-altering sex-rejecting procedures that carry serious long-term health risks and lack sufficiently reliable evidence of clinical benefit. The final rule ends the use of federal Medicaid and CHIP funds to pay for these procedures on...
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CMS' mandatory VBC programs brought substantial administrative costs for hospitals: study
Four mandatory value-based payment programs were associated with more than $3 billion in aggregated administrative costs compared to non-participating hospitals, researchers' analysis of Medicare cost reports found.
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Texas’ ACA enrollment ‘boom’ didn’t happen after all
Not all CMS data is telling the same story when it comes to ACA enrollment in Texas. As of January, nearly 4.2 million Texans had selected ACA plans for 2026, up from nearly 4 million in 2025. That marked the largest enrollment increase of any state. A previous KFF analysis found Texas had the highest […] The post Texas’ ACA enrollment ‘boom’ didn’t happen after all appeared first on Becker's Payer Issues | Payer News .
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STAT+: A RAPID proposal for breakthrough coverage, and nurses push back on AI
In this edition of STAT Health Tech: Details from CMS and FDA on the RAPID pathway for breakthrough devices, and nurses push back on AI.
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Medicare Program; Regulatory Alignment for Predictable and Immediate Device (RAPID) Coverage Pathway
This notice with comment period provides information to the public on the process CMS will use to provide accelerated Medicare coverage through the Regulatory Alignment for Predictable and Immediate Device (RAPID) coverage pathway for new innovative technologies. The RAPID coverage pathway leverages existing processes to provide expedited national Medicare coverage for eligible technologies. This notice with comment period solicits public comment on the proposed RAPID coverage pathway.
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Arkansas requests 2-year extension of Medicaid expansion waiver
Arkansas is seeking CMS’ approval of a two-year extension for the Section 1115 waiver enabling the state’s Medicaid expansion program, Arkansas Health and Opportunity for Me. Arkansas Department of Human Services Secretary Janet Mann sent CMS a letter Aug. 5 detailing the request. The letter follows CMS’ denial of the waiver’s renewal past 2026, affecting […] The post Arkansas requests 2-year extension of Medicaid expansion waiver appeared first on Becker's Payer Issues | Payer News .
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CMS Announces Resources, Flexibilities to Assist with Public Health Emergency in the State of Washington
CMS Announces Resources, Flexibilities to Assist with Public Health Emergency in the State of Washington The Centers for Medicare & Medicaid Services (CMS) announced today additional resources and flexibility available in response to a Public Health Emergency (PHE) in Washington state due to emergency conditions resulting from major wildfires, including the Fairview, Autumn Lane, and Old Trails fires near Spokane County beginning Aug.1, 2026, and continuing. CMS is working closely with Washin...
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CMS lifts enrollment suspension on Maryland Medicare Advantage plan
CMS has lifted the enrollment suspension it imposed on Provider Partners Health Plans’ Maryland I-SNP after the insurer corrected network deficiencies. The agency suspended enrollment into the plan in late May after Provider Partners’ lost all contracted long-term care facilities in its network and then disenrolled 29 members from the program without their consent. In […] The post CMS lifts enrollment suspension on Maryland Medicare Advantage plan appeared first on Becker's Payer Issues | Pay...