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.
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 flexibility to help people in Guam and the Northern Mariana Islands affected by Super Typhoon Bavi, which began on July 2, 2026. CMS is providing support to healthcare providers so they can continue to care for those ...
Calendar Year (CY) 2027 Home Health Prospective Payment System Proposed Rule Fact Sheet (CMS-1844-P)
The Centers for Medicare & Medicaid Services (CMS) has proposed new rules for home health agencies that will take effect on July 1, 2026. These changes aim to reduce fraud and ensure that Medicare payments only go to compliant providers. Key proposals include making all enrollment revocations retroa...
CMS Proposes Updates to Strengthen Medicare Program Integrity, Combat Fraud, and Expand Access to Home Health Care
The Centers for Medicare & Medicaid Services (CMS) is making changes to strengthen the Medicare program and reduce fraud. These updates will help ensure that only compliant providers can participate in Medicare, which is expected to save taxpayers about $82 million each year. The new rules will also...
CMS Acts to Strengthen Care Quality, Cut Drug Costs, and Slash Out-of-Pocket Expenses for Medicare Beneficiaries
The Centers for Medicare & Medicaid Services (CMS) has announced changes to how Medicare pays for outpatient care, which will start in 2027. These changes aim to lower drug costs and out-of-pocket expenses for Medicare beneficiaries. CMS plans to adjust payment rates for drugs purchased under the 34...
Calendar Year 2027 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Proposed Rule (CMS-1850-P)
On July 2, 2026, the Centers for Medicare & Medicaid Services (CMS) proposed new payment rules for hospital outpatient services and Ambulatory Surgical Centers (ASCs) for the year 2027. This change will impact around 3,500 hospitals and 6,400 ASCs. The proposed updates include a 2.4% increase in pay...
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 Takes Bold New Approach to Stewarding Medicaid Demonstration Project Spending
The Centers for Medicare & Medicaid Services (CMS) is changing how it oversees Medicaid demonstration projects to ensure they don't cost taxpayers more money. Starting January 1, 2027, any new or renewed demonstration projects must be certified as budget neutral by the CMS Chief Actuary, meaning the...
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 ...