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 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...
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...
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...
2027 Medicare Advantage and Part D Rate Announcement
The Centers for Medicare & Medicaid Services (CMS) announced new payment rates for Medicare Advantage (MA) and Part D plans for the year 2027. These changes will increase payments to MA plans by about 2.48%, which is over $13 billion in total. This increase is based on various factors, including cha...
Contract Year 2027 Medicare Advantage and Part D Final Rule
The Centers for Medicare & Medicaid Services (CMS) has announced changes to the Medicare Advantage and Part D programs for the year 2027. These updates aim to enhance the quality of care for beneficiaries by revising the Star Ratings system, which helps people compare health and drug plans. Notably,...
Medicare Beneficiaries to See Simpler and More Flexible Plan Choices, Better Drug Coverage, Higher Quality and Lower Costs in 2027
Starting in 2027, Medicare beneficiaries will have simpler and more flexible options for their health plans. The Centers for Medicare & Medicaid Services (CMS) is making it easier to understand and compare Medicare Advantage and prescription drug plans. These changes aim to improve the quality of ca...
Fiscal Year 2027 Medicare Inpatient Psychiatric Facility Prospective Payment System Proposed Rule (CMS-1847-P)
On April 2, 2026, the Centers for Medicare & Medicaid Services (CMS) proposed updates to how Medicare pays for Inpatient Psychiatric Facilities (IPFs) starting in fiscal year 2027. The proposed changes include a 2.3% increase in payment rates, adjustments to outlier payments, and the removal of two ...
CMS Proposed Rule Locks in Lower Prices and Fosters Innovation for the Medicare Drug Price Negotiation Program
The Centers for Medicare & Medicaid Services (CMS) has proposed a new rule to create a permanent system for negotiating drug prices for Medicare beneficiaries. This change aims to lower drug costs and provide more stability for drug manufacturers involved in these negotiations. Starting in 2029, CMS...
Coming Soon: CMS to Provide $50 Monthly Access to GLP-1 Medications for Medicare Beneficiaries
Starting July 1, 2026, Medicare beneficiaries will be able to access certain GLP-1 medications for just $50 a month. This program, called the Medicare GLP-1 Bridge, will run until December 31, 2027, and aims to make these important weight-loss treatments more affordable for seniors. Eligible individ...
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...
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...
Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; and Quality Reporting Programs; Including the Hospital Outpatient Quality Reporting Program and Ambulatory Surgical Center Quality Program; Request for Information on Strengthening the Standardization and Comparability of Hospital Price Transparency (HPT) Data; Prior Authorization; Accrediting Organization (AO) Deeming for Emergency Medical Treatment and Labor Act (EMTALA); and Notices of Cl
The Medicare program is proposing changes to how hospitals and outpatient surgical centers are paid starting in 2027. This affects healthcare providers who use the Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgical Center (ASC) payment system. The new rules will update...