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The Latest Breaking News from CMS

Advocacy Group Says a Medicare Rule Change Delayed Price Negotiation for a Costly AbbVie Drug by Seven Years

Public Citizen says a CMS eligibility change kept AbbVie's Creon out of Medicare price negotiation for seven extra years. Here is how it works.

Medical Daily · Aug 10

Hospitals Will Report Which Implants Go into Which Patients Under a New Medicare Measure

Medicare will require hospitals to capture unique device identifiers for implants starting in 2027, addressing a longstanding recall notification gap.

Medical Daily · Aug 8

Iowa Auditor Says Nursing Home Inspections Now Meet Federal Standards After Years of Delay

Iowa nursing homes are now inspected every 12 months on average, meeting federal standards, the state auditor says. The agency disputes the report.

Medical Daily · Aug 7

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Federal Officials Urge States to Tighten Medicaid Oversight of Autism Therapy After 421 Percent Spending Rise

CMS released a state toolkit urging tighter Medicaid oversight of ABA autism therapy after spending rose 421 percent in four years.

Medical Daily · Aug 7

Nevada Doctor Charged in $95 Million Medicare Scheme Over Wound Coverings Used on Hospice Patients

A Henderson physician faces federal charges over $95 million in Medicare billing for amniotic wound grafts applied to elderly patients.

Medical Daily · Aug 7

Federal Health Officials Held Closed-Door Meetings with AI Companies, Raising Questions About Who Shapes Adoption Policy

FDA and CMS held a closed-door clinical AI event with 10 tech companies. What is routine, what is disclosed, and why patient groups want access.

Medical Daily · Aug 6

Kathy Hochul Slams Trump Over Medicare Cut, Says 1.3 Million New Yorkers Will Pay More for Prescriptions: 'A New Assault on Seniors...'

New York Governor Kathy Hochul (D) said President Donald Trump’s decision to end a Medicare subsidy program will raise prescription drug costs for about 1.3 million New Yorkers, arguing seniors should not have to bear the additional expense.

Benzinga · Aug 6

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Medicaid Enrollees with Chronic Illness Face a Documentation Test After a Judge Declined to Pause the Rule

A federal judge let the CMS medical frailty rule stand. Here is what chronically ill Medicaid enrollees will need to document and when.

Medical Daily · Aug 6

Medicare Will Require Breakthrough Devices to Prove Substantial Clinical Improvement for Extra Hospital Payments

CMS has closed the fast track that let breakthrough devices skip the clinical improvement test for extra Medicare hospital payments.

Medical Daily · Aug 5

Trump admin weaponizes imagined fraud

Expert breaks down how Trump's health officials are trying to prove that Medicaid itself is wasteful

Salon · Aug 5

CMS Finalizes Medicare Hospice Payment Increase and New Patient Disclosure Rules for FY 2027

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule updating Medicare hospice payment rates, the hospice wage index, and quality reporting...

Saving Advice · Aug 4

Medicare to Increase Payments for Inpatient Rehabilitation Facilities in FY 2027

The Centers for Medicare & Medicaid Services (CMS) has published a final rule updating payment rates for inpatient rehabilitation facilities (IRFs) under Medicare for federal...

Saving Advice · Aug 4

A Michigan Hospital Took a Federal Rural Lifeline, Watched ER Volume Fall 13 Percent, and Closed Anyway

Sturgis Hospital's ER volume fell 13 percent after it converted to the federal rural emergency model. Then it closed. What that signals for rural care.

Medical Daily · Aug 4

ACA Enrollment Falls to 19.2 Million as Coverage Drops in Every State but New Mexico

New KFF data show ACA enrollment fell in every state except New Mexico. Here is how coverage loss affects prescriptions, screenings, and re-enrollment options.

Medical Daily · Aug 4

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Medical Daily · Aug 4

Waiting on a Wheelchair or Home Oxygen? Six Questions to Ask Your Supplier Before Medicare's October Rules Start

New Medicare paperwork rules for wheelchairs, ventilators and oxygen start October 28. Here is what to ask your equipment supplier to avoid delivery delays.

Medical Daily · Aug 4

Medicare Will Require a Documented Doctor Visit Before Delivering Home Ventilators and Most Wheelchairs Starting October 28

CMS added home ventilators, eight wheelchair codes and an oxygen system to Medicare's face-to-face and written order list, effective October 28.

Medical Daily · Aug 3

Medicare Will Start Counting Advantage Patients in Hospital Quality Scores, Closing a Gap That Left Out Half the Program

CMS finalized changes adding Medicare Advantage patients to hospital mortality and readmission measures, which have largely relied on fee-for-service claims.

Medical Daily · Aug 3

FDA Names Its First Company in a Pilot That Lets Some Digital Health Devices Skip Premarket Review

The FDA selected Dexcom as the first participant in its TEMPO pilot, which pairs relaxed premarket review with real-world evidence collection.

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Medical Daily · Aug 3

New Federal Rules Put Hospital Malnutrition Screening and Advance Care Planning in the Spotlight

Medicare will require hospitals to report malnutrition screening and advance care planning. Both address gaps that affect recovery and family decisions.

Medical Daily · Aug 3

Medicare Finalizes New Rules for the Hospitals Where Stroke Patients Begin Intensive Recovery

CMS finalized FY 2027 rules for inpatient rehabilitation facilities, tightening when therapy must start and when care teams must meet. What patients should know.

Medical Daily · Aug 3

Sepsis Survivors Are Often Readmitted Within a Month, and Discharge Planning Is Where That Changes

Medicare will start scoring hospitals on 30-day sepsis readmissions. Here is what survivors and caregivers should ask before discharge day.

Medical Daily · Aug 3

Cancer and Long-Term Care Hospitals Will Stop Reporting Staff COVID Vaccination Rates Under a Finalized Medicare Rule

CMS finalized removal of staff COVID vaccination reporting for 11 cancer hospitals and long-term care hospitals, beginning with the FY 2028 program year.

Medical Daily · Aug 3

Hospitals Must Now Name Their Perinatal Quality Collaborative Under a Finalized Medicare Reporting Change

CMS finalized a rule requiring hospitals to name the perinatal quality collaborative they join, starting with FY 2028. What it means for families.

Medical Daily · Aug 3

A New Medicare Rule Changes How Organ Recovery Costs Are Accounted For, with No Projected Effect on Waiting Lists

Medicare finalized changes to how organ procurement organizations account for costs. Here is what it does, and why it is unlikely to change transplant waits.

Benzinga · Aug 3

Medicaid Recipients Are Beginning to Lose Coverage as Nebraska Becomes First State to Enforce New Federal Work Requirements

States are entering the first phase of implementing new federal Medicaid work requirements, with Nebraska becoming the first state where some beneficiaries are beginning to lose coverage after failing to meet the reporting requirements.

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