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 Prevents $1.6 Billion in Fraudulent Medicare Laboratory Payments
The Centers for Medicare & Medicaid Services (CMS) has successfully stopped over $1.6 billion in fraudulent payments to Medicare laboratories. This includes the removal of 157 fraudulent lab providers from the Medicare program, which saved $732 million. CMS is using advanced technology, like artific...
Strengthening Original Medicare
The Center for Medicare is making changes to strengthen Original Medicare, which includes Parts A and B, affecting around 70 million Americans. They aim to improve access and affordability for beneficiaries while ensuring that Original Medicare remains a strong option alongside Medicare Advantage. K...
Manufacturer Effectuation of MFP Draft Guidance for 2028 Medicare Drug Price Negotiation
The Centers for Medicare & Medicaid Services (CMS) has released draft guidance for drug manufacturers regarding the implementation of the Maximum Fair Price (MFP) for certain drugs in 2028. This guidance outlines the processes manufacturers must follow to ensure that the agreed-upon prices are acces...
Calendar Year (CY) 2027 Medicare Physician Fee Schedule Proposed Rule
The Centers for Medicare & Medicaid Services (CMS) has proposed new rules for Medicare payments starting January 1, 2027, which will affect how physicians and other healthcare providers are paid under the Physician Fee Schedule (PFS). The proposed changes aim to improve the quality and efficiency of...
Calendar Year (CY) 2027 Medicare Physician Fee Schedule Proposed Rule (CMS-1848-P) — Medicare Shared Savings Program Proposals
The Centers for Medicare & Medicaid Services (CMS) has proposed changes to the Medicare Shared Savings Program for 2027. These changes aim to improve financial incentives for Accountable Care Organizations (ACOs) and encourage participation, especially from those serving higher-risk populations. Key...
CMS Proposes Transformational Medicare Reforms to Expand Accountable Care, Modernize Physician Payment, and Shift from Sick Care to Healthcare
The Centers for Medicare & Medicaid Services (CMS) is making major changes to Medicare that will affect healthcare providers and patients. These reforms aim to make it easier for doctors and hospitals to work together in groups called accountable care organizations (ACOs), which focus on preventing ...
Fiscal Year 2027 Medicare Inpatient Psychiatric Facility Prospective Payment System Final Rule (CMS-1847-F)
The Centers for Medicare & Medicaid Services (CMS) has updated the payment rules for Inpatient Psychiatric Facilities (IPFs) for the fiscal year 2027. Payments will increase by 2.3%, which translates to an additional $60 million for IPFs compared to the previous year. Starting in fiscal year 2028, t...
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...
Medicare Part D 2027 National Average Monthly Bid Amount Information
The Centers for Medicare & Medicaid Services (CMS) has released preliminary information about Medicare Part D bids for 2027, which will help plan sponsors prepare for the upcoming Medicare Open Enrollment. The average monthly bid amount for 2027 is set at $296.05, and the base beneficiary premium wi...
CMS Launches Medicare GLP-1 Bridge, Expanding Access to GLP-1 Medications
The Centers for Medicare & Medicaid Services (CMS) has introduced a new program called the Medicare GLP-1 Bridge. This program allows eligible Medicare beneficiaries to access certain GLP-1 medications for just $50 a month. It aims to help those who need these medications for weight management and i...
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...
June 1-5 is Medicare Fraud Prevention Week. Here’s How Americans Can Help Protect Themselves and Medicare.
June 1-5 is Medicare Fraud Prevention Week, a time to raise awareness about protecting Medicare from fraud. This week highlights the ongoing efforts by the Centers for Medicare & Medicaid Services (CMS) to safeguard taxpayer dollars and ensure beneficiaries receive the care they need. In 2025, CMS s...
Medicare.gov Enhanced Log In
The Centers for Medicare & Medicaid Services (CMS) has introduced new login options for Medicare.gov. This change allows Medicare users to manage their health care information more easily and securely. Users can access general Medicare information without an account, but if they choose to create one...
2026 Medicare Accountable Care Organization Initiatives Participation Highlights
In 2026, Medicare is increasing participation in Accountable Care Organizations (ACOs), which are groups of doctors and healthcare providers working together to improve patient care while managing costs. This change aims to provide better health outcomes for millions of older Americans by ensuring t...
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 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...
Medicare.gov Enhanced Log In
The Centers for Medicare & Medicaid Services (CMS) has introduced new login options for Medicare.gov that enhance security for users. People with Medicare can now create an account or verify their identity using services like ID.me, CLEAR®, and Login.gov, which provide extra protection against fraud...
2026 Medicare Accountable Care Organization Initiatives Participation Highlights
Starting January 2026, more Medicare beneficiaries will receive care through Accountable Care Organizations (ACOs), increasing from 13.7 million to 14.3 million. ACOs are groups of healthcare providers that work together to deliver better coordinated care, which helps improve health outcomes and red...