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.
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.
CMS proposes 2027 Exchange regulations focused on lowering premiums, expanding plan flexibility, and strengthening subsidy oversight and program integrity for payers.
