Healthcare Reimbursement News

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

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

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…

By Nick Hut November 23, 2025

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…

By Nick Hut November 20, 2025

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.

By HFMA November 19, 2025
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