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CMS releases update on post-shutdown provider claims
The Centers for Medicare & Medicaid Services released an updated notice Nov. 20 on the processing of Medicare provider claims impacted by the government shutdown.
CMS releases details on Medicare premiums, deductibles for 2026
The Medicare Part A deductible for inpatient hospital services will increase by $60 in calendar year 2026 to $1,736, the Centers for Medicare & Medicaid Services
Government shutdown ends as President Trump signs funding bill into law
The 43-day government shutdown ended late Nov. 12 when President Trump signed a funding bill into law, hours after the House passed the measure by a 222-209 vote.
AHA shares concerns, recommendations with CMS on WISeR model
The AHA Oct. 23 recommended changes to the Centers for Medicare & Medicaid Services’ Wasteful and Inappropriate Services Reduction model to address multiple concerns.
CMS proposes increasing payment rates by 2.6% in CY 2025
The Centers for Medicare & Medicaid Services July 10 issued a proposed rule that would increase Medicare hospital outpatient prospective payment system rates by a net 2.6% in calendar year 2025 compared to 2024. This includes a proposed 3.0% market basket update, offset by a 0.4 percentage point cut for productivity.
CMS releases guide on prior authorization submissions, determinations under WISeR model
The Centers for Medicare & Medicaid Services has released an operational guide for Medicare-enrolled providers and suppliers on the Wasteful and Inappropriate Service Reduction model.
OIG says MA, Medicaid managed care plans have limited, inaccurate behavioral health provider networks
A report by the Department of Health and Human Services Office of the Inspector General found that many Medicare Advantage and Medicaid managed care plans offer access to a limited proportion of behavioral health providers, and inaccurately list 72% of in-network behavioral health care providers as being available.
Medicare open enrollment for 2026 begins
Medicare open enrollment for 2026 began Oct. 15 and runs through Dec. 7.
AHA encourages MedPAC to refine analysis of MA enrollment impacts on patients, providers
The AHA Oct. 3 responded to the Medicare Payment Advisory Commission’s recent analysis on the financial impacts of Medicare Advantage enrollment growth on hospitals, which found that increased enrollment is not statistically associated, on average, with all-payer hospital margins.