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CMS announces actions addressing fraud

The Centers for Medicare & Medicaid Services Feb. 25 released a request for information on potential regulatory changes in a possible future proposed rule called Comprehensive Regulations to Uncover Suspicious Healthcare, or CRUSH.
Fraud, Medical Device Purchasing, Medicaid, Medicare

CMS announces library of digital health apps for Medicare beneficiaries 

The Centers for Medicare & Medicaid Services Feb. 23 announced the development of its Medicare App Library. As part of the agency’s Health Technology Ecosystem framework, the library will provide a directory for Medicare beneficiaries to access an array of patent-facing digital health tools integrated with CMS Aligned Networks.
Medicare, Technology, Artificial Intelligence (AI)

CBO projects Hospital Insurance Trust Fund to be solvent until 2040 

The Congressional Budget Office has projected that the Hospital Insurance Trust Fund will have sufficient funds to pay full benefits until 2040 — 12 years earlier than last year’s projection.
Medicare

Study finds nearly 3 million MA beneficiaries forced to find alternative coverage for 2026 

A JAMA study published Feb. 18 found that 10% of Medicare Advantage beneficiaries — approximately 2.9 million — have needed to find other health coverage in 2026 due to MA plans leaving the market.
Medicare Advantage

AHA submits comments on CMS proposed rule on prohibiting ‘sex-rejecting procedures’ for children

The AHA Feb. 17 submitted a comment letter responding to the Centers for Medicare & Medicaid Services’ proposed rule that would prohibit hospitals participating in the Medicare and Medicaid programs from performing “sex-rejecting procedures” on individuals under 18 years of age.
Medicaid, Medicare, Child and Adolescent Health

Senate Aging Committee holds hearing on physician burnout 

The Senate Special Committee on Aging held a hearing Feb. 11 on issues impacting physician burnout.
Legislation and Legislative Advocacy, Workforce, Geriatric, Medicare Advantage, Workplace Violence

CMS announces state distribution of $50 billion in rural health funds

The Centers for Medicare & Medicaid Services Dec. 29 announced $50 billion in funds awarded to all 50 states through the Rural Health Transformation Program.
Rural issues, One Big Beautiful Bill Act (OBBBA), Advocacy & Public Policy, Access to Behavioral Health, Medicare, Capacity Planning, Reimbursement

House passes AHA-supported hospital-at-home extension bill

The House Dec. 1 passed the Hospital Inpatient Services Modernization Act (H.R. 4313), legislation extending certain Medicare waivers authorizing the hospital-at-home care program for five years.
Medicare, Hospital at Home

Analysis: MA insurers made 53 million prior authorization determinations in 2024

A KFF analysis released Jan. 28 found that Medicare Advantage insurers made nearly 53 million prior authorization determinations in 2024, an increase from 49.8 million in 2023.
Health Insurance, Medicare Advantage

CMS proposes Medicare Advantage, Part D payment changes for CY 2027 

The Centers for Medicare & Medicaid Services Jan. 26 released proposed changes to Medicare Advantage plan capitation rates and Part D payment policies for calendar year 2027, which the agency estimates will result in a net average year-over-year increase of 0.09% in MA plan payments, or $700 million.
Medicare Advantage, Medicare