340B changes loom as the program attracts congressional, White House scrutiny
Both Congress and the White House are proposing 340B Drug Pricing Program changes that could add administrative burdens and ultimately limit the available savings for hospitals. A new report issued by Republican members of the Senate Health, Education, Labor and Pensions (HELP) Committee calls for changes that include requiring 340B covered entities to “provide detailed…
FY 2026 IPPS/LTCH PPS Proposed Rule Summary
HFMA presents a detailed summary of the proposed rule describing FY 2026 policies and rates for Medicare’s IPPS and LTCH PPS.
2026 Medicare Advantage – Part D Final Rule Summary
HFMA provides a detailed summary of the final rule revising regulations affecting Medicare Advantage, Medicare Prescription Drug Benefit, Medicare cost plans, and Programs of All-Inclusive Care for the Elderly.
CMS seeks feedback on applying MAHA guidelines in the U.S. healthcare system
The Medicare FY26 proposed rule for hospital inpatient payments offers clues as to how the Trump administration will seek to integrate principles of the Make America Healthy Again (MAHA) movement in the healthcare infrastructure. The rule includes a request for information (RFI) on using mandatory hospital quality measurement to foster improvements in nutrition and physical…
A new Trump executive order sets the stage for lower 340B payments
Hospitals can anticipate a regulatory effort to lower the Medicare payments they receive for purchases of Part B drugs through the 340B Drug Pricing Program. President Donald Trump on April 15 signed a wide-ranging executive order on drug costs, and one of the provisions directs HHS to conduct a survey of hospital acquisition costs for…
Medicare’s FY26 inpatient hospital proposed rule includes a restrained payment update
The Trump administration’s first set of Medicare proposals establishing inpatient payment rates continued what hospital advocates describe as a long-term trend in which the annual update is lacking. A 3.2% increase in the market basket would be reduced by a 0.8% statutory productivity adjustment, according to the newly released FY26 proposed rule. Hospitals that meet…
How the 340B remedy payments will affect upcoming Medicare Advantage payment rates
Hospital advocates found reason for concern in a narrow aspect of the Medicare Advantage (MA) final payment rate notice for 2026. With health plans lauding the average 5.06%, $25 billion revenue increase they’re projected to reap in the upcoming year, hospitals may wonder about adverse impacts from an applied reduction in CMS’s calculation of the…
Final 2026 rule for MA, Part D leaves out proposed GLP-1 drug coverage
The Trump administration’s final rule setting policy and technical changes for Medicare Advantage (MA) in 2026 did not carry forward a proposal regarding GLP-1 drug coverage, but key provider-focused provisions were retained. The rule, which is scheduled for formal publication April 15 and also sets 2026 Medicare Part D policies, excludes a Biden administration proposal…
Questions about Medicaid cuts are unresolved in latest budget reconciliation blueprint (updated)
Note: This article was updated April 10 with the latest news on steps forward in the reconciliation process and a rollback of a specific set of funding by CMS. As released this week, the Senate’s latest budget reconciliation blueprint provides few answers about the impact a final bill could have on federal healthcare spending, in…
HHS restructures for the DOGE era
A massive HHS restructuring announced March 27 could have an indirect impact on providers. Secretary Robert F. Kennedy Jr. announced HHS would reduce its workforce by 10,000 FTEs, part of a 25% downsizing from 82,000 to 62,000, with previously announced early retirements and buyouts also factoring into the count. The department’s agencies will be pared…