In annual rule, CMS finalizes new regulatory curbs on Medicare physician payments
Medicare has cued up its first physician payment increase in six years, but policy changes will bring new financial constraints for hospital-based physicians and many specialties. A 2026 final rule ushers in limitations on payments for a wide array of physicians. After factoring in budget neutrality requirements, the policies appear to boost independent primary care…
Rural Health Transformation Program’s application deadline arrives, bringing states and hospitals a step closer to billions in funding dollars
In the final days before the application deadline for the $50 billion Rural Health Transformation Program (RHTP), states and hospitals were scrambling to present the relevant information to CMS in the best possible light. Nov. 5 is the deadline to for states to apply for a share of the $10 billion that will be made…
340B rebate model is set to proceed in 2026 with 9 drugs
A new chapter for the 340B Drug Pricing Program will begin Jan. 1 after the Health Resources and Services Administration (HRSA) formally authorized a rebate model last week. For 2026, eight approved manufacturers can provide rebates rather than upfront discounts to 340B participating providers dispensing nine drugs: The list of drugs for the rebate model…
How specialty drugs are remaking healthcare and driving up costs
This article has been updated with news of additional policies announced by the Trump administration. Accelerating healthcare costs have less to do with traditional hospital and physician services than with surging drug spending, an industry expert says. “When we can’t really see any trends in healthcare utilization increasing, the only thing that consistently shows up…
Senate hearing on 340B reflects congressional interest in altering the program
A leading healthcare policymaker in Congress sounds intent on modifying the 340B Drug Pricing Program. Sen. Bill Cassidy (R-La.), chair of the Senate Committee on Health, Education, Labor and Pensions (HELP), led a 340B-focused hearing Oct. 23 during which he called for changes. “If this committee is serious about making healthcare more affordable, about making…
The healthcare payroll hit stemming from termination of the Affordable Care Act enhanced subsidies
Healthcare providers would be at risk of losing more than 150,000 jobs in 2026 if the higher Affordable Care Act (ACA) marketplace subsidies expire at the end of this year, according to a new analysis. In the analysis published by the Commonwealth Fund, researchers used economic modeling to project that providers would lose 154,000 jobs…
Hospital merger tally increases as organizations come to grips with the policy environment
Hospital merger-and-acquisition (M&A) activity accelerated in Q3 2025, indicating that executive teams are getting a handle on the prospective impact of major healthcare policies. “Now that the One Big Beautiful Bill has passed, hospitals and health systems have more policy clarity to inform their growth strategies,” Anu Singh, managing director at Kaufman Hall, which published…
Senate committee examines ways to strengthen the supply chain for hospital drugs
Vulnerabilities in the supply chain for pharmaceuticals are putting patients at risk and hampering healthcare providers, according to testimony at a recent Senate hearing. The flaws manifest in shortages of vital drugs and in issues of quality and transparency, experts said during the Oct. 8 hearing of the Senate Special Committee on Aging. In Q1…
OIG report could lead to additional inspection of hospitals’ Provider Relief Fund usage
Some hospitals that received funding support from HHS during the COVID-19 pandemic may need to prepare for additional auditing based on findings of a report by the department’s Office of Inspector General (OIG). The report examined a small sampling of Provider Relief Fund (PRF) recipients and found that 17 of 25 hospitals did not comply…
No Surprises Act arbitration has been a bonanza for a few provider groups
In a span of 2.5 years through 2024, providers reaped more than $2.2 billion from the No Surprises Act’s arbitration process, relative to the applicable in-network payment rates for the disputed care episodes. The awards received through the NSA’s independent dispute resolution (IDR) process largely arise from “disputes that are primarily initiated and won by…