Insurance News
Regulatory updates in plain English
Stay current with the latest from CMS, state departments of insurance, NAIC, the Federal Register, and Congress — rewritten so you can actually understand what it means for your practice.
HHS and CMS Announce First Meeting of Healthcare Advisory Committee
The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) are holding the first meeting of the Healthcare Advisory Committee on May 18 at 2 p.m. This meeting will introduce the Committee members, explain their goals, and set the rules for how they ...
CMS Announces Manufacturer Participation in Third Cycle of Medicare Drug Price Negotiation
The Centers for Medicare & Medicaid Services (CMS) has announced that drug manufacturers will participate in the third round of negotiations for Medicare drug prices. This change affects pharmaceutical companies that provide medications covered under Medicare. Agents should stay informed about these...
CMS Strengthens Patient Protections and Accountability in Organ Donation System
The Centers for Medicare & Medicaid Services (CMS) has updated its guidelines to improve protections for patients and their families involved in the organ donation process. This change aims to ensure that patients' rights are better safeguarded and that the organ donation system is more accountable....
CMS Proposes Regulations to Lower Health Care Costs, Expand Consumer Choice, and Protect Taxpayers
The Centers for Medicare & Medicaid Services (CMS) has proposed new rules aimed at lowering health care costs and improving choices for consumers. These changes will affect health insurance agents and brokers by increasing accountability and reducing fraud in the industry. The goal is to make health...
CMS to Lower Drug Costs and Improve Care by Extending Deadline for GENEROUS Model Application
The Centers for Medicare & Medicaid Services (CMS) has extended the application deadline for drug manufacturers to join the GENEROUS Model, which aims to reduce drug costs and improve care in Medicaid. The new deadline is now April 30, 2026, instead of March 31, 2026. This change allows more drug co...
CMS Announces Manufacturer Participation in Third Cycle of Medicare Drug Price Negotiation
The Centers for Medicare & Medicaid Services (CMS) has announced that drug companies are participating in the third round of negotiations for Medicare drug prices. This affects 15 specific high-cost drugs that are covered under Medicare Part B and Part D. These negotiations aim to lower the prices o...
CMS to Lower Drug Costs and Improve Care by Extending Deadline for GENEROUS Model Application
The Centers for Medicare & Medicaid Services (CMS) has extended the application deadline for drug manufacturers to join the GENEROUS Model, which aims to reduce drug costs in Medicaid and improve healthcare access. The new deadline is now April 30, 2026, giving manufacturers more time to apply. This...
CMS Strengthens Patient Protections and Accountability in Organ Donation System
The Centers for Medicare & Medicaid Services (CMS) has introduced new guidelines to improve the organ donation process, ensuring that patients and their families receive respectful and compassionate care. These guidelines clarify that hospitals must provide full medical treatment to all patients, re...
CMS Proposes Regulations to Lower Health Care Costs, Expand Consumer Choice, and Protect Taxpayers
The Centers for Medicare & Medicaid Services (CMS) has proposed new rules aimed at lowering health care costs and improving choices for consumers. These changes will affect health insurance agents and brokers by tightening regulations to prevent fraud and ensure that taxpayer-funded subsidies are us...
CMS Rule Phases Out Fax Machines, Snail Mail to Save Taxpayers $781.98 Million a Year
The Centers for Medicare & Medicaid Services (CMS) is ending the use of fax machines and traditional mail to save money and improve efficiency. This change will affect healthcare providers who submit claims and documentation. By moving to electronic transactions, the healthcare industry is expected ...
Readout: CMS Convenes First Rural Health Transformation Summit to Advance State-Led Innovation
The Centers for Medicare & Medicaid Services (CMS) has launched a new $50 billion program aimed at improving healthcare in rural areas. This initiative, called the Rural Health Transformation Program, will help states enhance their rural health systems, increase access to care, and manage chronic di...
CMS Marks Milestone in Expanding Patient-Centered Innovation with Substance Access Beneficiary Engagement Incentive
Starting April 1, 2026, certain healthcare organizations can offer a new incentive that allows doctors to include eligible hemp-derived products in patient care plans. This initiative, called the Substance Access Beneficiary Engagement Incentive (BEI), is part of a broader effort by the Centers for ...
CMS Finalizes 2027 Medicare Advantage and Part D Payment Policies that Strengthen Accountability and Long-Term Sustainability
The Centers for Medicare & Medicaid Services (CMS) have announced new payment policies for Medicare Advantage (MA) and Part D for the year 2027. These changes will increase payments to MA plans by an average of 2.48%, totaling over $13 billion. The goal is to improve payment accuracy and ensure that...
Administrative Simplification; Adoption of Standards for Health Care Claims Attachments Transactions and Electronic Signatures Final Rule CMS-0053-F
The Centers for Medicare & Medicaid Services (CMS) has introduced new rules that set standards for electronically sharing health care claims attachments, like medical records and lab results. This means that health care providers can now send important documents securely and quickly without using fa...
HHS and CMS Announce Healthcare Advisory Committee Members to Improve Patient Care and Modernize the U.S. Healthcare System
The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have formed a new Healthcare Advisory Committee. This group, made up of healthcare leaders, will provide advice on improving patient care and modernizing the healthcare system, including Med...
CMS Announces Resources, Flexibilities to Assist with Public Health Emergency in Guam and the Commonwealth of the Northern Mariana Islands
The Centers for Medicare & Medicaid Services (CMS) has announced new resources and flexibilities to help those affected by the Public Health Emergency in Guam and the Northern Mariana Islands due to Super Typhoon Sinlaku. This includes support for healthcare providers to ensure they can continue to ...
CMS Proposes New Transparency Measures to Strengthen Oversight of Hospice Providers
The Centers for Medicare & Medicaid Services (CMS) is introducing a new scoring system for hospice providers to improve oversight and transparency. This system will help identify hospices that may be misusing Medicare funds or providing poor care, while allowing legitimate providers to continue thei...
Fiscal Year (FY) 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements Proposed Rule (CMS-1851-P)
The Centers for Medicare & Medicaid Services (CMS) has proposed new rules for hospice care payments and reporting for fiscal year 2027. These changes will affect hospice providers by increasing payment rates by 2.4%, which amounts to about $785 million more than the previous year. However, hospices ...