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Medicare & Medicaid

By Susan Morse | 10:21 am | December 22, 2025
The longer duration, along with improved benchmarks and risk adjustment, is expected to attract a broader range of ACOs.
By Susan Morse | 11:23 am | December 18, 2025
On Jan. 1, impacted payers will have limited time to respond to prior authorization requests, as mandated in the Interoperability and Prior Authorization final rule.
By Susan Morse | 10:32 am | December 11, 2025
CMS distributed $3.3B to providers experiencing revenue disruptions, including $2.2B to hospitals, report says.
By Susan Morse | 11:05 am | December 08, 2025
Humana has the ability to grow MA membership while diversifying into higher star-rated plans, analyst says.
By Susan Morse | 09:34 am | December 04, 2025
The mandate, put into place under the Biden administration, burdened facilities, especially those serving rural and Tribal communities, HHS says.
By Nathan Eddy | 03:44 pm | December 03, 2025
Starting January 1, 340B hospitals will pay large sums upfront to buy drugs at the full wholesale acquisition price, lawsuit says.
By Susan Morse | 10:44 am | December 03, 2025
Providers expected worse, as CMS originally proposed a 6.4% payment cut.
By Susan Morse | 11:30 am | December 02, 2025
The brief, two-page notice filed the day before Thanksgiving gives no basis for the appeal.
By Susan Morse | 11:30 am | November 26, 2025
CMS is proposing to remove measures focused on administrative processes or that do not convey variability in quality among plans.
By Susan Morse | 11:12 am | November 26, 2025
CMS announces billions in savings for Medicare when first and second rounds of negotiations go into effect in 2026 and 2027, respectively.