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Member

Update: Congress Passes Health Care Funding, Extends Key Health Care Provisions

Congress has passed the Consolidated Appropriations Act of 2026 (H.R.7148), which consists of a short-term continuing resolution for the Department of Homeland Security (DHS) appropriations bill and a package of five full-year appropriations bills, containing conferenced legislation for the Departments of Defense, Labor, Health and Human Services, Education,
Legislation and Legislative Advocacy, Medicaid, Medicare, Medicare Sequestration Payment Reductions, Cybersecurity, Rural issues, Workforce, Child and Adolescent Health, Maternal Health, Medical Education and Research, Access to Behavioral Health, Substance Use Disorder, Disaster Preparedness, 340B Drug Pricing Program
Member

Implications for Hospitals and Health Systems as Partial Government Shutdown Looms

Specific government agency funding, including programs within the Department of Health and Human Services, is set to expire at midnight Jan. 30.
Advocacy & Public Policy, Legislation and Legislative Advocacy, Conditions of Participation, Medicare, Disaster Preparedness, Access to Behavioral Health, Substance Use Disorder
Member

CMS Issues Proposed Rule for CY 2027 Medicare Advantage, Prescription Drug Plans

The Centers for Medicare & Medicaid Services (CMS) Nov. 28 released its proposed Policy and Technical Changes to the Medicare Advantage (MA) Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program and Programs of All-Inclusive Care for the Elderly for Contract Year (CY) 2027.
Medicare Advantage, Drug Prices, Prescription Drugs
Member

CMS Issues CY 2026 Physician Fee Schedule Final Rule

The Centers for Medicare & Medicaid Services (CMS) Oct. 31 issued a final rule that updates physician fee schedule (PFS) payments for calendar year (CY) 2026.
Physician Fee Schedule (PFS)/MACRA/QPP, Outpatient Prospective Payment Systems (OPPS), Telehealth, Medicare, Ambulatory and Outpatient Care, Behavioral Health Care Delivery, Medicare, Merit-based Incentive Payment System (MIPS), Interoperability, Medicare Physician Payment
Member

Hospital Outpatient, Ambulatory Surgical Center Proposed Rule for CY 2026

The AHA is disappointed that CMS proposes an inadequate Medicare outpatient hospital payment update, as many hospitals — especially those in rural and underserved communities — operate under challenging financial pressures.
Outpatient Prospective Payment Systems (OPPS), Ambulatory Surgical Center (ASC), Medicare, Medicaid, Site-Neutral Payment Proposals
Member

CMS Issues CY 2026 Physician Fee Schedule Proposed Rule

CMS July 14 issued a proposed rule that would update physician fee schedule (PFS) payments for calendar year (CY) 2026.
Physician Fee Schedule (PFS)/MACRA/QPP, Telehealth, Medicare, Behavioral Health Care Delivery, Medicare
Member

AHA Summary of House Energy and Commerce Legislative Language

The House Energy and Commerce Committee May 11 released bill text in advance of its May 13 markup. The committee has been instructed to reduce deficits by $880 billion, with significant Medicaid cuts being considered.
Legislation and Legislative Advocacy, Budgeting, Medicaid, Medicare
Member

FY 2026 Transforming Episode Accountability Model Proposed Rule

The Centers for Medicare & Medicaid Services (CMS) April 11 issued its hospital inpatient prospective payment system (PPS) and long
Transforming Episode Accountability Model (TEAM), Quality Measures, Medicare
Member

Updated Medicare Advantage Question and Complaint Process for Provider Organizations

CMS has released an updated complaint form with instructions for Medicare providers seeking assistance from the Centers for Medicare & Medicaid Services (CMS) in resolving Medicare Advantage (MA) claims issues.
Medicare Advantage
Member

CMS Issues Rate Announcement and Final Rule for CY 2026 Medicare Advantage, Prescription Drug Plans

The Centers for Medicare & Medicaid Services (CMS) earlier this month released its rate announcement and final rule on Policy and Technical Changes to the Medicare Advantage, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly for contract year (CY) 2026.
Medicare Advantage