Beginning July 1, 2026 through Dec. 31, 2027, Medicare beneficiaries with Part D coverage may be eligible to access certain GLP-1 medications for $50 per month.
Are You Required to Participate in Medicare’s New Payment Model? Check the CMS List to Find Out
As previously reported by ACOI, the Centers for Medicare and Medicaid Services (CMS) will launch two new payment models for heart failure and lower back pain on January 1, 2027.
Insurers Make Prior Authorization Data Available to Public
A new federal transparency requirement is making health plan prior authorization data publicly available for the first time—including for many Medicare Advantage (MA), Medicaid managed care, CHIP, and Affordable Care Act Marketplace plans.
CMS Encourages Providers to Prepare for e-Prior Authorization
Starting January 1, 2027, certain health plans regulated by the Centers for Medicare and Medicaid Services (CMS) must implement and maintain Application Programming Interfaces (APIs) to support electronic prior authorization.
The Medicare Payment Advisory Commission issued its March 2026 Report to the Congress: Medicare Payment Policy, providing a comprehensive, data-driven assessment of current Medicare payment systems.
House Lawmakers Introduce Bill to Improve Physician Payment Stability
Legislation has been introduced in the U.S. House of Representatives that would make improvements to budget neutrality requirements within the Medicare physician fee schedule (PFS).
New Bill Exempts Health Care Professionals from H-1B Fee
Representatives Maria Elvira Salazar (R-FL), Mike Lawler (R-NY), Yvette Clarke (D-NY), and Sanford Bishop (D-GA) introduced the H1Bs for Physicians and the Healthcare Workforce Act (H.R. 7961).
CMS Rule Phases Out Fax Machines; Sets New Standards for Exchange of Clinical Documentation for Health Care Claims
The Centers for Medicare and Medicaid Services (CMS) has released a final rule that will phase out fax machines and paper mailings for health care claims documentation and establish national standards for the electronic exchange of clinical documentation.
CMS Boosts MA Plan Rates After Pushback from Insurers
On April 6, the Centers for Medicare and Medicaid Services (CMS) announced it will provide Medicare Advantage (MA) plans a 2.48 percent rate increase in 2027.
