MACPAC Issues Report to Congress
The Medicaid and CHIP Payment and Access Commission has sent its 2026 report to Congress. The report – mandated by Congress – includes recommendations for: overseeing community engagement/work requirements in Medicaid, including MedPAC’s recommendation that the Centers for Medicare & [...]
MedPAC Reports to Congress
The Medicare Payment Advisory Commission has issued its annual report to Congress. This year’s report examines: how Medicare payment incentives affect federal spending and the delivery of care and how those incentives can be improved the challenges beneficiaries encounter when [...]
Federal Health Policy Update for June 11
The following is the latest health policy news from the federal government for June 5-11. Some of the language used below is taken directly from government documents. Don’t Miss: CMS warns more than 500 hospitals for failing to meet price [...]
Marketplace Enrollment Declines
With the elimination of enhanced premium tax credits, enrollment in Affordable Care Act health insurance exchange plans is falling. Last year saw 24 million people enroll in ACA marketplace plans – an all-time high. 2026 enrollment, though, is down 1.2 [...]
CMS Warns Hospitals About Price Transparency
The Centers for Medicare & Medicaid Services has written to more than 500 hospitals, warning them that they are failing to meet federal requirements for price transparency. The letter warns hospitals that they are at risk of fines if they [...]
ASH Comments on Proposed FY 2027 Medicare Inpatient Payment Rule
The Alliance of Safety-Net Hospitals has submitted formal comments in response to the Centers for Medicare & Medicaid Services’ proposed Medicare inpatient prospective payment system regulation for FY 2027. Highlights of ASH’s comments include: The assertion that the proposed Medicare [...]
CMS Defines “Medical Frailty” for Medicaid Eligibility Purposes
With the federal government about to implement a work/community engagement requirement for eligibility for Medicaid coverage, regulators have attempted to define what constitutes “medical frailty” as a reason for exemption from that requirement. In a new report, KFF explains that [...]
Federal Health Policy Update for June 4
Don’t miss: CMS publishes new Medicaid work/community engagement requirements Energy and Commerce Committee looks at price transparency in health care An AI executive order and Congress prepares to weigh in Price cut: IDR dispute fee to fall from $115 [...]
A 340B Scorecard
Hospitals suing CVS Health over 340B savings. The Health Resources and Services Administration’s proposed 340B Rebate Model Pilot Program. Eli Lilly’s demand that hospitals share claims-level data for 340B-covered drugs. The continuing battle over the involvement of contract pharmacies in [...]
CMS Proposes New Medicaid Eligibility Requirements
The Centers for Medicare & Medicaid Services has published an interim final rule implementing the Medicaid work/community engagement requirements mandated by H.R. 1, last year’s federal budget reconciliation bill. The rule defines community engagement requirements for adults to gain or [...]
