Reimbursement

Contract Year 2026 Medicare Advantage Plan Provider Directory Data Requirements Final Rule Summary

HFMA provides a detailed summary of the final rule finalizing a previously proposed Medicare Advantage plan provider directory requirement.

By HFMA September 23, 2025

CMS describes how $50 billion will be distributed for rural healthcare

Correction: The lead paragraph of this story was updated after initially referring to the program as the Rural Hospital Transformation Program. The Trump administration announced the application period for the Rural Health Transformation Program, giving states an opportunity to claim a piece of a $10 billion FY26 allotment on behalf of their hospitals and clinics.…

By Nick Hut September 15, 2025

A large health system says revenue could fall by at least $50 million if the ACA subsidies expire

With time running short to maintain enhanced subsidies for the Affordable Care Act (ACA) insurance marketplaces, health system leaders are trying to gauge the consequences of a potential mass disenrollment. Universal Health Services (UHS), a for-profit system that operates more than 400 care sites, is one of the few healthcare organizations to have publicly released…

By Nick Hut September 12, 2025

HFMA Comments on Revisions to Payment Policies under the CY 2026 Medicare PFS, Quality Payment Program and Other Revisions to Part B

HFMA submits comments pertaining to Proposed Rule CMS-1832-P Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2026.

By HFMA September 11, 2025

CMS gives updates on upcoming Medicaid state-directed payment limits

CMS has issued guidance to Medicaid programs about implementing required restrictions on the state-directed payments (SDPs) made through Medicaid managed care organizations (MCOs). The budget reconciliation law known as the One Big Beautiful Bill Act (OBBBA) includes a provision that all SDPs submitted after July 4 for hospitals must be limited to the Medicare rate…

By Nick Hut September 9, 2025

Senate, House release diverging HHS budget proposals for FY26 (updated-2)

Note: This article was updated Sept. 16 with news about a short-term continuing funding resolution and Sept. 10 with new numbers for some provisions in the House appropriations bill. Sept. 16 update Republicans in the House are focusing on a short-term continuation of FY25 federal funding as the most direct route to avoiding a partial…

By Nick Hut September 5, 2025

FY 2026 Hospice Payment Rate Update Final Rule Summary

HFMA presents a detailed summary of the final rule updating the Medicare hospice payment rates, wage index, and Hospice Quality Reporting Program for FY 2026.

By HFMA September 3, 2025

Court limits CMS’s authority to immediately apply the ACA marketplace program integrity final rule

A federal judge blocked many of the Trump administration’s plans to constrict enrollment in Affordable Care Act (ACA) marketplace health plans in the name of program integrity. In an Aug. 22 ruling, Judge Brendan Hurson (a Biden appointee) of the U.S. District Court for Maryland issued a stay of key provisions of a CMS final…

By Nick Hut August 28, 2025

Rethinking rev cycle, plus the 2026 Medicare proposed rule on physician fee schedule

Mayank Pant from IKS Health talks about why healthcare organizations haven’t been able to overcome longstanding challenges, and Nick Hut talks with HFMA Policy Director Katie Gilfillan about the 2026 Medicare Proposed Rule on physician fee schedule.

By Erika Grotto August 25, 2025

CY 2026 Physician Fee Schedule Proposed Rule Summary Part III – Quality Payment Program Updates

HFMA presents part III of three detailed summaries of the proposed rule relating to the Medicare physician fee schedule for CY 2026 and other revisions to Medicare Part B policies.

By HFMA August 22, 2025
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