The Centers for Medicare and Medicaid Services has finalized risk adjustment policies in a final rule to prevent overpayments to Medicare Advantage Organizations. Studies and audits done separately by ...

Hospitals have warned the move could threaten funding for providers that serve low-income and vulnerable patients.

The Centers for Medicare and Medicaid Services has issued a final rule on Significant, Anomalous and Highly Suspect (SAHS) billing activity in the Medicare Shared Savings Program. The final rule ...

The 2027 Medicare home health proposed payment rule dropped yesterday, and it was a surprising one. The home health industry ...

Days before the 2024 presidential election, the Centers for Medicare & Medicaid Services (CMS) released an unpublished version of the final calendar year 2025 physician fee schedule (PFS) final rule.

On November 1, 2024, CMS issued a rule finalizing changes to Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B policies effective on or after January 1, 2025 (the ...

CMS has released its final rule for Medicare Advantage and Part D for 2026, introducing several regulatory changes aimed at improving care coordination and beneficiary protections. While the rule ...

While the US takes the holiday weekend to celebrate the country’s independence, the nation’s skilled nursing providers are girding for what federal authorities may present them with in their annual ...

A coalition of 26 states is suing the Trump administration over its rollout of Medicaid work requirements. | A coalition of ...

CMS proposes paying 340B-acquired drugs at ASP minus 33.4% starting CY 2027, replacing ASP plus 6%, based on survey findings that acquisition costs are well below ASP. Projected 2027 impact includes ...

The Centers for Medicare & Medicaid Services (CMS) released its Interim Final Rule with Comment (IFC) requiring certain adult Medicaid applicants and enrollees to meet conditions of eligibility ...