Medicare payment policy changes for 2027: Key signals from Kennedy hearings
Amid ample rancor, some of the rhetoric during congressional appearances Thursday by HHS Secretary Robert F. Kennedy Jr. had substantive implications for healthcare industry stakeholders. During two House hearings to discuss his department’s proposed FY27 budget, Kennedy and members of the Ways and Means Committee and a subpanel of the Appropriations Committee touched on a…
H-1B visa fee strains the healthcare workforce and hospital finances
In the year after implementation of a new White House policy curtailing the pipeline for legal immigration, the healthcare industry is grappling with the implications. In September, the Trump administration announced that the H-1B visa program for skilled workers seeking to enter the U.S. would carry a $100,000 fee per application. Healthcare, along with higher…
HFMA members urged to evaluate and reply to prospective new GASB statement
HFMA’s Principles and Practices Board encourages healthcare providers who follow governmental accounting standards to carefully evaluate and provide feedback on GASB Statement No. 103, particularly as it relates to the classification and treatment of subsidies. The Governmental Accounting Standards Board (GASB) has issued proposed implementation guidance addressing the application of subsidy-related guidance. The proposed approach…
CMS FY27 rule expands bundled payments, adjusts Medicare inpatient reimbursement rate
For the first time, a value-based payment model is set to become mandatory for almost all hospitals nationwide. The expansion of the Comprehensive Care for Joint Replacement (CJR) bundled payment model is a headlining provision of the newly released Medicare FY27 proposed rule for hospital inpatient services and long-term care hospitals (LTCHs). Also in the…
In a first, a drugmaker’s lawsuit challenges HRSA’s 340B patient definition
In a new chapter for litigation involving the 340B Drug Pricing Program, a drugmaker is suing the federal government over the definition of patient as it pertains to the program. AbbVie Inc. says the definition established by the Health Resources and Services Administration (HRSA) in 30-year-old guidance is unwieldy and enables inappropriate access to 340B…
Medicare Advantage 2027 payment update increases after a CMS revision
Belying earlier projections, CMS gave Medicare Advantage (MA) health plans a payment hike for 2027. Payments will increase by 2.48%, or more than $13 billion, according to a final rate notice published April 6. It’s a better outcome for stakeholders than was anticipated when CMS released the advance rate announcement in January. Then, the payment…
Trump’s FY27 HHS budget proposal outlines cuts, operational changes
President Donald Trump’s healthcare budget proposal for FY27 emphasizes Making America Healthy Again (MAHA) priorities and slashes operational costs within HHS. At $111.1 billion, total HHS funding would decrease by $15.8 billion, or $12.5%, relative to FY26. When counting onetime recissions, the effective cut would be nearly $23 billion (from $112.3 billion in FY26 to…
ACA marketplace enrollment declines as subsidies expire in 2026
CMS’s latest 2026 enrollment numbers for the Affordable Care Act (ACA) marketplaces indicate a relatively moderate drop-off from 2025, although the final tally could look notably different. The agency reported this week that 23.1 million were enrolled at the close of open enrollment for Healthcare.gov and the state-run marketplaces. That’s a 4.9% decline from 2025,…
DOJ brings antitrust lawsuits challenging hospital contracting practices
Litigation brought by the U.S. Department of Justice (DOJ) asserts anticompetitive behavior in contracting by two health systems. The allegations in lawsuits filed Feb. 20 against OhioHealth and March 26 against NewYork-Presbyterian (NYP) connect to concerns in the Trump administration about the impact of dominant health systems in some markets. Repeated references in the lawsuits…
Health system PBM ownership model shows benefits amid reform pressure
Amid heightened scrutiny of the pharmacy benefit manager (PBM) model, one health system is touting an alternative approach. St. Louis-based SSM Health is co-owner of Navitus Health Solutions, a PBM with 18 million members among 800 clients across all 50 states. Navitus has a niche that helps it optimally serve customers while bolstering the operation…