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.
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.
2026 Medicare final rule postpones a significant payment cut for hospitals
While implementing several policies that could constrain hospital finances next year and beyond, CMS offered temporary relief on one count. The Medicare 2026 final rule for hospital outpatient departments and ambulatory surgical centers (ASCs) was proposed to include an across-the-board 2% cut to base payments. But CMS, acknowledging the concerns of hospitals, kept the scheduled…
Senate hearing doesn’t resolve 2026 funding for Affordable Care Act marketplace plans
Senate Republicans used a recent hearing to press their case for enacting immediate reforms to part of the Affordable Care Act (ACA), with little sign they will agree to extend the subsidy framework that has been in place for more than four years. During the Nov. 19 hearing of the Senate Finance Committee, members of…
CY 2026 Physician Fee Schedule Final Rule Summary – Part I
HFMA presents part one 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 would take effect on January 1, 2026. Part I covers sections I through III.G (except for Section III.F: Medicare Shared Savings Program Requirements) and the Regulatory Impact Analysis.
CMS gives new guidance on upcoming restrictions to Medicaid provider taxes
CMS issued preliminary guidance about how it will implement new restrictions on Medicaid provider taxes as required by the budget reconciliation law known as the One Big Beautiful Bill Act (OBBBA). OBBBA language will curb provider taxes as a Medicaid funding mechanism through which states can increase their allotment of federal matching dollars that, in…
Aetna delays and modifies new policy that’s set to hit reimbursement for inpatient hospital stays
Hospitals received a brief reprieve from a pending Aetna payment policy that remains likely to decrease reimbursement starting in 2026. In a prior announcement, Aetna said it would apply level-of-severity criteria to all urgent or emergent hospital admissions lasting at least one midnight for Medicare Advantage (MA) and Medicare Special Needs Plans patients. For stays…
Government funding deal would extend key healthcare programs but not Affordable Care Act enhanced subsidies
Note: This article has been updated with additional comments from members of Congress. Important healthcare funding could be restored in a matter of days, with an agreement to end the government shutdown now in sight. The Senate struck a deal Nov. 9 to advance a federal funding bill for a formal vote, with eight Democrats…
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…
The shutdown continues, plus the latest on 340B
HFMA Senior Editor Nick Hut and HFMA Policy Director Shawn Stack discuss the latest in healthcare finance news.