HHS and CMS announce a new Healthcare Advisory Committee to guide policy, improve patient care, and modernize healthcare delivery across federal programs.
CMS Expands Claims Attachments Final Rule Webinar to Open Town Hall Format This Top Stories update highlights a recent CMS announcement expanding access to its
HHS proposes the HTI-5 rule to reduce Health IT certification requirements and reshape AI interoperability standards. The public comment period closed February 27, 2026, signaling upcoming regulatory changes.
OIG flags nursing home antipsychotic fraud, CMS weighs Medicare Advantage auto-enrollment, and MedPAC reports $76B in MA overpayments — March 22, 2026.
State Medicaid Budgets Will Decline by $665 Billion Under New Federal Law This Top Stories report summarizes a recent Stateline article outlining the projected $665
CMS Final Rule Eliminates Fax and Mail for Claims Attachments CMS finalizes electronic claims attachment and e-signature standards, replacing fax and mail to reduce administrative
By March 31, 2026, impacted payers must publicly post prior authorization metrics for calendar year 2025 under CMS-0057-F. That includes data tied to approval and denial rates, appeal outcomes, turnaround times, and the items and services subject to prior authorization.
CMS has issued new guidance strengthening patient protections and accountability in the organ donation system, with implications for payers around transplant network oversight, OPO recertification, and member care navigation through 2027.
Industry Watch Alert Home The Centers for Medicare & Medicaid Services announced it is extending the application deadline for prescription drug manufacturers to participate in
The Trump Administration announced expanded fraud prevention actions across Medicare and Medicaid, signaling a shift toward real-time oversight, increased transparency, and heightened program integrity expectations for payer organizations.
