Medicare & Medicaid
The CR would extend Medicare telehealth flexibilities, including acute hospital care at home and allow for retroactive payments.
Expected drop in next year’s star ratings will be due to the health equity index that includes social risk factors in CMS calculations.
AHA has “substantial concerns” over the vendor payment structure in WISEeR that incentivizes denials at the expense of physician judgment.
States are asked to send letters of intent to apply for the GENEROUS model that launches in 2026.
One health system told the ATA it would cost $1 million a year to comply with the billing mandates of the physician fee schedule final rule.
The lawmakers say the tool used by CMS is riddled with errors, while beneficiaries have not been notified.
Around 800 laboratory tests will be subject to the payment cuts on Jan. 1, 2026, threatening patient access to diagnostics, letter says.
States want early and clear guidance from CMS so they can move forward with system upgrades ahead of the Jan. 1, 2027, deadline.
Managed Medicaid plans offer suggestions on rollout of work requirements.
The 2.5% increase was voted into law in July in the One Big Beautiful Bill Act.