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The Latest Breaking News from CMS

Bill Miller Vertical Health Services: A Leader Shaped by the People He Serves

He was 17 years old, pushing a mop through the hallways of a skilled nursing facility, when two residents pulled him aside and handed him a wedding invitation.

inkl · Aug 31

Florida Health System Agrees to $541.5 Million Settlement Over Medicare Advantage Diagnosis Codes

A Florida healthcare provider has agreed to a massive $541.5 million settlement with the federal government over allegations that unsupported diagnosis codes helped drive up Medicare Advantage payments.

The Free Financial Advisor · Aug 27

Medicare's $50 Weight Loss Discount Excludes Millions Whose Conditions the Drugs Are Actually Approved to Treat

Medicare's GLP-1 Bridge charges $50 a month, but a sleep apnea or diabetes diagnosis routes patients back to Part D copays of hundreds of dollars.

Medical Daily · Aug 26

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Four Health Systems Compete for 92 Hospital Beds as Western North Carolina Residents Line Up Against Mission

Four health systems want 92 new hospital beds in western North Carolina, and residents told state regulators Mission should not get one more.

Medical Daily · Aug 26

Medicare's 50 Dollar GLP-1 Price Locks Out Nearly Six Million People Who Have a Qualifying Diagnosis

An estimated 5.9 million Medicare enrollees are excluded from the $50 GLP-1 Bridge price because they have diabetes or sleep apnea.

Medical Daily · Aug 26

Alabama Sends 144 Million Dollars to Rural Clinics for Maternity Care, Mental Health and Emergency Transport

Alabama announced 138 grants totaling more than $144 million for rural healthcare, funding maternity care, telehealth, and school mental health.

Medical Daily · Aug 26

The Federal Deal to Cut Medicaid Prices on Weight Loss Drugs Still Names No Participating States

CMS negotiated lower GLP-1 prices for state Medicaid programs through the BALANCE Model. Its own page still shows no participating states.

Medical Daily · Aug 25

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Four Health Systems Switch On Instant Insurance Checks Built into the Software Their Doctors Already Use

Four health systems went live with real-time prior authorization checks inside Epic, months before a federal deadline. It flags requirements, not decisions.

Medical Daily · Aug 24

The Kirkland Signature Care Plan? Costco Prepares Move Into Medicare Advantage

From bulk goods to healthcare coverage, Costco plans its expansion into senior health plans pending government approval.

Kiplinger · Aug 19

Aetna Will Not Pay Brokers on 123 Medicare Advantage Plans in 33 States for Next Year

Aetna told marketing organizations it will not pay commissions on 123 Medicare Advantage plans in 33 states for the 2027 plan year.

Medical Daily · Aug 19

Incyte Stock: Is Wall Street Bullish or Bearish?

While Incyte has outperformed the broader market over the past year, Wall Street analysts remain cautiously optimistic about the stock’s prospects.

Barchart · Aug 18

CMS Energy Stock: Is Wall Street Bullish or Bearish?

CMS Energy has underperformed the broader market over the past year, but analysts are moderately optimistic about the stock’s prospects.

Barchart · Aug 18

Nearly One in Five Medicare Hospice Patients Now Leaves the Program Alive Rather Than Through Death

Medicare data show hospice live discharges rose to 19.1 percent in fiscal 2025. Here is what triggers a discharge and what families can do next.

Medical Daily · Aug 17

HHS Refers Hospitals, Pharmacies and Benefit Managers to Federal Investigators Over Youth Gender Care Billing Codes

HHS referred health systems, pharmacies, and PBMs to the OIG and the Department of Justice for billing codes used for gender care in minors.

Medical Daily · Aug 17

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Latin Times · Aug 17

CMS Admitted Its NY Medicaid Fraud Number Was Wrong. The Crackdown Continued Anyway.

CMS admitted its Medicaid fraud claim against New York was off by a factor of ten. Weeks later, Washington cut the state's fraud-fighting funds anyway.

Saving Advice · Aug 17

CMS Ends Federal Medicaid and CHIP Funding for Certain Gender-Transition Care for Minors

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule prohibiting the use of federal Medicaid and Children’s Health Insurance Program (CHIP)...

The Free Financial Advisor · Aug 17

CMS Final Rule Ends Federal Medicaid and CHIP Funding for Certain Gender-Transition Care for Minors

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule prohibiting the use of federal Medicaid and Children’s Health Insurance Program (CHIP) funds to pay for what the rule terms “sex-rejecting procedures” for minors, according to an official announcement published in the Federal Register on August 13,…

Latin Times · Aug 15

Trump Administration Cuts Off Federal Medicaid and CHIP Funding for Trans Minors

Starting Oct. 13, a final CMS rule ends federal Medicaid and CHIP funding for youth transition care, leaving states to cover costs or enforce bans.

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Medical Daily · Aug 13

A New Federal Rule Cuts Medicaid Money for Gender Care in Minors, but States Can Still Pay with Their Own Funds

A CMS final rule ends federal Medicaid and CHIP matching funds for gender-related care in minors, taking effect on October 13, 2026.

Medical Daily · Aug 12

Rural Hospital Closures Slowed This Year While Individual Services Kept Disappearing

New federal cost report analysis puts 720 rural hospitals at risk of closing, even as whole hospital closures slow and service lines keep ending.

Medical Daily · Aug 12

Federal Program Will Send AI Health Tools into Rural America Before Evidence Shows They Improve Patient Outcomes

States are spending rural health funds on AI tools despite thin evidence that health AI improves access or outcomes in rural communities.

Medical Daily · Aug 11

Federal Records Show Two Connecticut Hospitals Drew More Serious Safety Citations Than Any Others in the State

Saint Francis Hospital has received nine immediate jeopardy citations since January 2023, the most of any Connecticut hospital, state records show.

Saving Advice · Aug 11

2027 Medicare Costs: What We Know Now—and What Seniors Are Still Waiting For

Anyone trying to build a retirement budget for next year is dealing with an awkward Medicare calendar: some important 2027 numbers are available, while others...

Medical Daily · Aug 11

The Same Knee Replacement Costs Twice as Much an Hour Apart, and the Price Files Now Show It

Federal price disclosure data show a knee replacement billed at about $16,000 at one North Carolina hospital and around $40,000 at another.

Medical Daily · Aug 11

Federal Reviewers Found Problems in Nearly 30 Percent of Cases at a Four-State Organ Procurement Group

HHS moved to decertify Network for Hope after federal reviews found concerning features in 103 of 351 organ donation cases examined.

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