Healthcare Reimbursement News

OBBBA Medicaid impacts: How to navigate state-directed payment revenue reduction 

On July 4, 2025, President Trump signed the One Big Beautiful Bill Act (OBBBA) into law, initiating one of the most significant shifts in federal fiscal policy in recent years. The legislation introduces sweeping tax reforms and spending reductions, with healthcare providers positioned to experience the most substantial impact.   OBBBA authorizes a $1 trillion reduction in federal Medicaid spending…

By HFMA December 18, 2025

Texas hospitals fall short in an appellate ruling about disproportionate share hospital payment calculations

An appeals court dealt hospitals a defeat in a case about Medicare disproportionate share hospital (DSH) payments, reversing a lower court’s prior ruling on jurisdictional grounds last week. A Dec. 9 decision by a three-judge panel at the U.S. Court of Appeals for the Fifth Circuit means certain Section 1115 waiver days can remain excluded…

By Nick Hut December 17, 2025

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. 18)

Dec. 18 update The only year-end healthcare legislation to pass at least one chamber of Congress does not include an extension of the Affordable Care Act (ACA) enhanced subsidies, but members have not given up on reaching an agreement in early 2026. House Republicans passed a bill Dec. 17 that includes provisions (see the Dec.…

By Nick Hut December 4, 2025
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