CMS on Nov. 21 finalized its Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System rule for 2026, enacting reforms to boost price transparency and expand ...
A new federal proposal is signaling a potential shift in how Medicare Advantage plans are evaluated and rewarded, raising questions about the future of quality metrics, insurer incentives, and patient ...
CMS has released a request for information seeking input on replacing its Medicare claims processing system with a real-time, cloud-based platform. Under the program, called ClaimsCore, CMS is seeking ...
CMS has improved its online enrollment system, formally the Medicare Provider Enrollment, Chain, and Ownership System, to allow providers to see if they need to revalidate their data and digitally ...
The Centers for Medicare & Medicaid Services is increasingly relying on a relatively new — and recently expanded — regulatory tool to quickly remove clinicians and companies from the Medicare system ...
A contract designed to modernize a provider enrollment system was publicly canceled, but has now been quietly removed from the Department of Government Efficiency’s ‘wall of receipts’ website. The ...
As we near the turnover of administrations, Health Affairs Forefront offers a series of articles from leaders at the Centers for Medicare and Medicaid Services providing their thoughts on the major ...
The feds have AI reviewing whether claims through traditional Medicare are 'medically necessary' — upending longstanding ...
On July 15, 2025, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2026 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems ...
The Centers for Medicare & Medicaid Services (CMS) has unveiled a comprehensive proposed payment rule designed to overhaul reimbursement policies. This initiative aims to reduce waste, improve chronic ...
Emanuel is vice provost for global initiatives and co-director of the Healthcare Transformation Institute at the Perelman School of Medicine and the Wharton School at the University of Pennsylvania.
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