CMS
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CMS and FDA unveil a fast track for Medicare access to breakthrough devices
Initial reactions to the new regulatory pathway from medtech industry groups ranged from mostly positive to cautious.
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CMS proposes to roll back add‑on payment pathway for breakthrough devices
A proposed rule change would require breakthrough devices to meet the same evidence standards as all other new technologies, reshaping reimbursement incentives starting in 2028.
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CMS issues final 2027 Medicare Advantage and Part D Payment Rates
Payor and provider groups are saying the rate increases may not be enough to stave off cuts to coverage.
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HHS and CMS announce committee to ‘modernize’ the US healthcare system
The 18-member Healthcare Advisory Committee will advise on how to best finance and deliver care across Medicare, Medicaid, CHIP, and the Health Insurance Marketplace.
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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.