CMS Releases Proposed Rule Establishing Electronic Standards for Drug Prior Authorizations
The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on April 10 to create electronic standards for drug prior authorizations, extending the 2024 rule that standardized medical‑service prior authorizations. The proposal requires payers to accept API‑driven requests, shorten decision timelines, and increase transparency. It also calls for replacing the legacy HIPAA X12 278 transaction with the new API standards. The move aims to modernize the prior‑auth workflow across Medicare and Medicaid programs.
CMS Releases FY 2027 Proposed Rule for Long-Term Care Hospitals
The Centers for Medicare & Medicaid Services (CMS) proposed a 2.4% increase in the standard rate payments for long‑term care hospitals (LTCHs) in fiscal year 2027, driven by a 3.2% market basket update offset by a 0.8% productivity adjustment. The...
CMS Issues Hospital IPPS Proposed Rule for FY 2027
The Centers for Medicare & Medicaid Services (CMS) released a FY 2027 proposed rule that would raise Medicare inpatient prospective payment system (IPPS) rates by a net 2.4%, adding roughly $1.9 billion in hospital payments. The increase reflects a 3.2% market‑basket rise...
CMS Highlights New Digital Health Ecosystem Tools
On April 9, the Centers for Medicare & Medicaid Services (CMS) staged a demonstration of the first wave of products for its newly announced Medicare App Library. More than 50 digital‑health companies showcased tools designed to streamline data access, eliminate...
MedPAC Urged by AHA to Scrutinize MA Impacts on Hospital and Post-Acute Provider Finances
The American Hospital Association (AHA) urged the Medicare Payment Advisory Commission (MedPAC) to closely examine how Medicare Advantage (MA) affects hospital and post‑acute provider finances. At its April 9‑10 meeting, MedPAC discussed MA enrollment trends and payment incentives, while the AHA...
CMS Issues Update on PAMA Data Reporting Webinar
The Centers for Medicare & Medicaid Services (CMS) posted an updated registration link for its April 16, 2024 webinar at 3 p.m. ET, which will cover the Medicare Clinical Laboratory Fee Schedule (CLFS) data collection process. The session will focus on new reporting...
Measles Cases Reach 583 in Utah Outbreak
The Utah measles outbreak surged to 559 confirmed cases as of March 31, according to the state Department of Health and Human Services, adding 107 cases in the prior three weeks. South Carolina’s outbreak is nearing 1,000 cases, with 991 reported...
Protecting Access to Care for Our Most Severely Ill Patients
Long‑term care hospitals (LTCHs) deliver intensive, extended treatment for the most severely ill Medicare beneficiaries. Since the 2016 dual‑rate payment system, Medicare reimbursements to LTCHs have dropped roughly 45%, contributing to a 25% decline in operating LTCHs over the past...
Webinar to Share Strategies on Workforce Relief
The American Hospital Association (AHA) is urging health leaders to register for its 2026 Annual Membership Meeting in Washington, D.C., which includes a webinar on workforce‑relief strategies. Recent data reveal flu vaccination at 76.3% and COVID‑19 vaccination at 40.2% among...
U.S. Birth Rate Declined 1% in 2025, CDC Finds
The U.S. maternal mortality rate slipped to 17.9 deaths per 100,000 live births in 2024, a figure statistically indistinguishable from the 18.6 recorded in 2023. While the rate has modestly improved, maternal deaths have doubled since 1987 and more than...
Mississippi 340B Law Upheld by Appeals Court in Two Cases
On April 9, 2026, the U.S. Court of Appeals for the Fifth Circuit upheld Mississippi’s law that protects 340B drug pricing for contract‑pharmacy arrangements. The court affirmed district‑court rulings rejecting injunction requests from Novartis, the Pharmaceutical Research and Manufacturers of America...
CMS Webinar, Video Detail New PAMA Data Reporting Requirements
The Centers for Medicare & Medicaid Services (CMS) will host a webinar on April 16 at 3 p.m. ET to walk laboratories through new data‑reporting requirements under the Protecting Access to Medicare Act (PAMA). The rules, which apply to hospital outreach, independent,...
AHA Podcast: A New Solution to Medical Debt
Undue Medical Debt, a nonprofit focused on eliminating patient financial burdens, announced that it has helped erase more than $27 billion in medical debt through its partnership model with hospitals. The organization works with health systems to identify unpaid balances, purchase...
HRSA to Provide More than $135 Million for Nutrition, Rural Workforce Initiatives
The Health Resources and Services Administration (HRSA) announced a funding package exceeding $135 million to boost nutrition services and rural health‑workforce development. About $125 million will be directed to more than 350 health centers to expand food‑based interventions within primary‑care settings. An...
CMS Releases Guidance on Limits to Medicaid, CHIP Funding for Certain Noncitizens
The Centers for Medicare and Medicaid Services (CMS) issued guidance on April 8, 2026 to implement a provision from the July 2025 reconciliation bill that limits federal matching funds for full Medicaid and CHIP benefits. Starting October 1, 2026, federal match will be available...
