Author: brad

The Centers for Medicare & Medicaid Services (CMS) is taking action to preserve the core mission of the Medicaid program by putting an end to spending that duplicates resources available through other federal and state programs or isn’t directly tied to healthcare services.  Mounting expenditures, such as covering housekeeping for individuals who are not eligible… Read more

As Dr. Mehmet Oz completes his first week as the 17th Administrator of the Centers for Medicare & Medicaid Services (CMS), he is sharing his agenda and vision for the agency. A cardiothoracic surgeon and former host of an award-winning TV show, he now leads the largest agency under the Department of Health and Human… Read more

Today, the Centers for Medicare & Medicaid Services (CMS) released the Final Calendar Year (CY) 2026 Part D Redesign Program Instructions (the Final CY 2026 Program Instructions) concurrently with the Announcement of CY 2026 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (the CY 2026 Rate Announcement). Read more

Today, the Centers for Medicare & Medicaid Services (CMS) released the Announcement of Calendar Year (CY) 2026 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (the CY 2026 Rate Announcement).  In the CY 2026 MA and Part D Advance Notice, CMS proposed updates to payment factors for CY 2026 and received… Read more

Today, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2026 Rate Announcement for the Medicare Advantage (MA) and Medicare Part D Prescription Drug Programs that finalizes the payment policies for these programs. This release — combined with the CY 2026 MA and Part D final rule that was released on… Read more

The Centers for Medicare & Medicaid Services (CMS) issued a final rule on April 4, 2025, that modernizes and improves Medicare Advantage (MA), Medicare Prescription Drug Benefit (Part D), Medicare cost plan, and Programs of All-Inclusive Care for the Elderly (PACE) programs. The Contract Year (CY) 2026 MA and Part D final rule implements changes related… Read more

Today, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule to address the troubling amount of improper enrollments impacting Affordable Care Act (ACA) Health Insurance Marketplaces across the country. CMS’ 2025 Marketplace Integrity and Affordability Proposed Rule includes proposals that take critical and necessary steps to protect people from being enrolled in… Read more

Introduction Today, the Centers for Medicare & Medicaid Services (CMS) issued the “Marketplace Integrity and Affordability Proposed Rule” that proposes standards for the Health Insurance Marketplaces, as well as for health insurance issuers, brokers, and agents who connect millions of consumers to Affordable Care Act (ACA) coverage. The rule proposes additional safeguards to protect consumers… Read more

What’s changing:  Today, the CMS Innovation Center announced changes to its model portfolio to align with its statutory obligation and strategic goals.  Innovation Center Models are time-limited experiments that provide a controlled environment to determine, through rigorous evaluation, what approaches should be expanded nationwide, what specific components of an approach need further testing in successor… Read more

The Centers for Medicare and Medicaid Services (CMS) Innovation Center is committed to testing – and eventually scaling – innovative payment models that meet the statutory goals of reducing program spending while maintaining or improving quality of care. Read more