Healthcare Reimbursement News

MedPAC finds the hospital industry is on a more stable financial footing now

Hospitals do not need a Medicare payment boost for 2027 beyond the update to be provided in the statutory formula, says the Medicare Payment Advisory Commission (MedPAC). Whereas the commission had recommended that Congress increase hospital payments by an additional 1% or 1.5% ahead of each year from 2024 through 2026, the recommendation for 2027…

By Nick Hut December 15, 2025

2026 Physician Fee Schedule Specialty Impact Tables

HFMA presents a specialty impact analyses contained in one spreadsheet based on the 2026 Medicare physician fee schedule final rule.

By HFMA December 12, 2025

Comparison of CY 2026 Physician Fee Schedule Payment Rates to the 2025 Payment Rates

HFMA presents a spreadsheet comparing 2026 physician fee schedule payment rates to 2025 payment rates.

By HFMA December 10, 2025

MedPAC December 2025 Public Meeting Summary

HFMA presents a detailed summary of the MedPAC public meeting held on the December 4-5, 2025.

By HFMA December 10, 2025

Questions loom over the future of telehealth policy

Federal telehealth policy continues to prove confounding for healthcare providers. The recent 43-day government shutdown marked the first extended period since the early days of the COVID-19 pandemic that traditional restrictions on telehealth reimbursement were in place. Medicare waivers of those restrictions helped telehealth utilization surge during the pandemic and remain elevated in the years…

By Nick Hut December 9, 2025

Contract Year 2027 Revisions to Medicare Advantage and Medicare Prescription Drug Benefit Programs Proposed Rule Summary

HFMA presents a detailed summary of a proposed rule that would revise the Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), and Medicare cost plan regulations for Contract Year 2027. Comments on the proposed rule are due by January 26, 2026.

By HFMA December 8, 2025

CY 2026 OPPS/ASC Final Rule Summary

HFMA presents a detailed summary of the CY 2026 final rule for Medicare’s hospital outpatient prospective payment system and ambulatory surgical center payment system (CMS-1834-FC) published in the November 25, 2025,Federal Register. Policies in the final rule will generally go into effect on January 1, 2026, unless otherwise specified.

By HFMA December 5, 2025

At the 11th hour, an Affordable Care Act subsidy accord remains elusive (updated Dec. 12)

Dec. 12 update House Republican leaders plan to hold a vote this coming week on legislation to address healthcare costs. The bill does not include an extension of the Affordable Care Act (ACA) enhanced subsidies, which are set to expire at year’s end. As a nod to moderates in the party who have pushed for…

By Nick Hut December 4, 2025

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

HFMA presents part three of three detailed summaries of a final rule relating to the Medicare physician fee schedule for CY 2026 and other revisions to Medicare Part B policies. Policies in the final rule generally will take effect on January 1, 2026. Part III covers the updates to the Quality Payment Program, including the Traditional Merit-based Incentive Payment System (MIPS), MIPS Value Pathways, and the Alternative Payment Model Incentive.

By HFMA December 4, 2025

CY 2026 Physician Fee Schedule Final Rule Summary Part II – MSSP Requirements

HFMA presents part two of three detailed summaries of the final rule relating to the Medicare physician fee schedule for CY 2026 and other revisions to Medicare Part B policies. The policies in this final rule generally take effect on January 1, 2026. Part II covers the Medicare Shared Savings Program Requirements.

By HFMA December 2, 2025
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