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CMS
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Elevance Health faces sanctions over data submission compliance
CMS alleges that the health insurance giant repeatedly provided risk adjustment data via unapproved external flash drives.
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CMS initiates ‘major’ crackdown on healthcare fraud
The initiative includes a nationwide moratorium for durable medical equipment (DMEPOS) suppliers and a freeze on $259.5m in federal Medicaid funding in Minnesota.
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HHS agency signals drug rebate program redux with request for information
The RFI is the Trump administration’s next move to get its drug pricing rebate program back on track after hospital groups blocked it last year.
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FCA Healthcare roundup: Three cases of Medicare and Medicaid fraud in IL, MN, NY
Our in-brief, biweekly roundup of notable US Department of Justice False Claims Act cases related to healthcare fraud.
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CMS rule proposal takes aim at Affordable Care Act plan options
The CMS administrator says the rule would lower costs and reinforce accountability, but critics say it’s designed to steer more consumers toward high-deductible plans.
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CMS proposes financial incentives for hospitals to buy American supplies
The proposed rule change appears to be an acknowledgement that shifting supply chains to domestic manufacturers would significantly strain hospital operating margins.
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CMS proposes flat rates for 2027 Medicare Advantage to ensure ‘sustainability’
The agency is also proposing a shift in the risk-adjustment model traditionally used in the MA program.
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AMA survey reveals state health policy priorities and challenges
The survey of the 64 physician organizations spotlights their leading healthcare priorities, defining the state-level legislative – and risk – landscape in 2026.