Medicare payment policy changes for 2027: Key signals from Kennedy hearings
Amid ample rancor, some of the rhetoric during congressional appearances Thursday by HHS Secretary Robert F. Kennedy Jr. had substantive implications for healthcare industry stakeholders. During two House hearings to discuss his department’s proposed FY27 budget, Kennedy and members of the Ways and Means Committee and a subpanel of the Appropriations Committee touched on a…
FY 2027 Inpatient Psychiatric Facilities PPS Proposed Rule Summary
HFMA presents a detailed summary of the FY 2027 Inpatient Psychiatric Facilities Prospective Payment System proposed rule, published in the April 7, 2026, Federal Register.
CMS FY27 rule expands bundled payments, adjusts Medicare inpatient reimbursement rate
For the first time, a value-based payment model is set to become mandatory for almost all hospitals nationwide. The expansion of the Comprehensive Care for Joint Replacement (CJR) bundled payment model is a headlining provision of the newly released Medicare FY27 proposed rule for hospital inpatient services and long-term care hospitals (LTCHs). Also in the…
FY 2027 Inpatient Rehabilitation Facility PPS Proposed Rule Summary
HFMA presents a detailed summary of the FY 2027 proposed rule updating the Medicare inpatient rehabilitation facility prospective payment system.
In a first, a drugmaker’s lawsuit challenges HRSA’s 340B patient definition
In a new chapter for litigation involving the 340B Drug Pricing Program, a drugmaker is suing the federal government over the definition of patient as it pertains to the program. AbbVie Inc. says the definition established by the Health Resources and Services Administration (HRSA) in 30-year-old guidance is unwieldy and enables inappropriate access to 340B…
Medicare Advantage 2027 payment update increases after a CMS revision
Belying earlier projections, CMS gave Medicare Advantage (MA) health plans a payment hike for 2027. Payments will increase by 2.48%, or more than $13 billion, according to a final rate notice published April 6. It’s a better outcome for stakeholders than was anticipated when CMS released the advance rate announcement in January. Then, the payment…
Trump’s FY27 HHS budget proposal outlines cuts, operational changes
President Donald Trump’s healthcare budget proposal for FY27 emphasizes Making America Healthy Again (MAHA) priorities and slashes operational costs within HHS. At $111.1 billion, total HHS funding would decrease by $15.8 billion, or $12.5%, relative to FY26. When counting onetime recissions, the effective cut would be nearly $23 billion (from $112.3 billion in FY26 to…
ACA marketplace enrollment declines as subsidies expire in 2026
CMS’s latest 2026 enrollment numbers for the Affordable Care Act (ACA) marketplaces indicate a relatively moderate drop-off from 2025, although the final tally could look notably different. The agency reported this week that 23.1 million were enrolled at the close of open enrollment for Healthcare.gov and the state-run marketplaces. That’s a 4.9% decline from 2025,…
MedPAC says hospital payments are sufficient, urges better safety-net targeting
Medicare payment to hospitals is broadly adequate but should be better targeted for lower-resourced facilities, according to a formal recommendation by the Medicare Payment Advisory Commission (MedPAC). In its annual report to Congress on Medicare payment policy, MedPAC said 2027 inpatient and outpatient payments should increase in accordance with the statutory formula and do not…
Hospitals targeted in healthcare affordability debate on Capitol Hill
Large employers are looking to put much of the impetus for improving healthcare affordability on hospitals, according to congressional testimony Wednesday. “Many of the biggest cost increases are driven by hospitals and health systems and can be addressed today,” Elizabeth Mitchell, president and CEO of the large-employer coalition Purchaser Business Group on Health (PBGH), said…