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 Proposed Rule [CMS-1834-P],...more
7/18/2025
/ Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Financial Services Industry ,
Healthcare ,
Healthcare Reform ,
Medicare ,
Outpatient Prospective Payment System (OPPS) ,
Payment Systems ,
Proposed Rules ,
Regulatory Requirements ,
Reporting Requirements
Health plan members of AHIP and the Blue Cross and Blue Shield Association made news earlier this week when they announced a series of steps that a broad swath of health insurers will take to improve the prior authorization...more
6/26/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Insurance Industry ,
Medicare Advantage ,
New Regulations ,
Prior Authorization ,
Regulatory Reform ,
Regulatory Requirements
This past week, the Trump administration put its first major stamp on the Medicare Advantage (MA) program. The Centers for Medicare & Medicaid Services (CMS) released two final regulatory documents related to MA:
- The...more
4/10/2025
/ Artificial Intelligence ,
Centers for Medicare & Medicaid Services (CMS) ,
Drug Pricing ,
Final Rules ,
Healthcare ,
Healthcare Reform ,
Inflation Reduction Act (IRA) ,
Medicare Advantage ,
Medicare Part D ,
Pharmaceutical Industry ,
Prescription Drugs ,
Regulatory Requirements ,
Risk Management ,
Rulemaking Process ,
Technology Sector
The Trump administration will have its own vision on value-based care, creating specific priorities for the Center for Medicare & Medicaid Innovation (CMMI), the federal government’s primary testing ground for payment and...more
2/26/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
CMMI ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Health Insurance ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Trump Administration ,
Value-Based Care ,
Value-Based Payments
A few weeks ago, Regs & Eggs provided insights into Medicare Advantage (MA), the private insurance option under Medicare, and explored both short- and long-term actions that the Trump administration could take to modify MA...more
2/13/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Insurance Industry ,
Medicare ,
Medicare Advantage ,
Medicare Part D ,
Proposed Rules ,
Regulatory Agenda ,
Trump Administration