Federal agency
Appears in 16 stories · Last updated Nov 10, 2026
Issued the rule and will enforce it
A home health agency that loses its Medicare billing privileges will now lose them back to the date its noncompliance began, not 30 days after the notice arrives. That change, buried in a 2027 payment rule, lets Medicare recoup payments made during the whole period a provider was out of compliance.
Updated Yesterday
Finalized the CY 2027 Physician Fee Schedule
Starting January 1, 2027, Medicare will pay about $19,441 when a sacroiliac joint fusion is performed in a physician's office. Until then, CPT 27279 had only a facility payment rate, so the procedure had no office rate at all.
Updated 2 days ago
Issued the final rule
Starting January 1, 2027, Medicare will pay hospitals 28% below the average sales price for drugs they buy through the 340B discount program. The final rule, issued November 4, replaces today's rate of average sales price plus 6% and exempts rural sole community hospitals, children's hospitals and cancer hospitals.
Updated 4 days ago
Issued the June 2026 interim final rule; its medically frail definition was vacated by the court
A federal judge in Boston struck down the Trump administration's rule narrowing who counts as 'medically frail' under Medicaid work requirements. Judge Richard Stearns vacated the disputed language on October 29, siding with 25 states and the District of Columbia. The ruling blocks enforcement of the test against the plaintiff states.
Updated Oct 31
Set a flat $127.14 per square centimeter rate from January 1, 2026; proposed keeping it for 2027
Aroa Biosurgery published results from a randomized controlled trial showing its Symphony wound product heals diabetic foot ulcers faster than standard care. In the company's headline analysis, 55% of ulcers closed within 12 weeks with Symphony, versus 35% with standard care alone. The study appeared in the International Wound Journal.
Updated Oct 26
Administers the Transparency in Coverage rules
Health insurers must publish their negotiated rates in a form researchers and consumers can use. The Department of Health and Human Services finalized the updates to the Transparency in Coverage rules on October 5, 2026, with the Departments of Labor and the Treasury.
Updated Oct 21
Pays a Medicare add-on of up to $3,380 per eligible PearlMatrix TLIF case in FY 2027
Hospitals that use PearlMatrix for lumbar fusion can now claim part of its extra cost back from Medicare. The payment took effect October 1, 2026, and for the first year the maximum add-on is $3,380 per case.
Updated Oct 20
Proposing first-ever physician reimbursement for VAERS reporting
The federal government opened a dedicated clinic at the National Institutes of Health this month to study and treat people reporting health problems after vaccination. It's the centerpiece of a new agency-wide push by the Department of Health and Human Services (HHS) to document, investigate, and respond to vaccine injuries. An internal memo obtained by NPR says NIH plans an observational study of vaccinated people and possible complications, and may examine vaccine schedules and treatments.
Updated Oct 17
Carried out Aug. 31 cancellations; reinstated some wrongly canceled enrollees; cut subsidies for 189,000 duplicate/deceased enrollees in October
On Aug. 31, CMS canceled 315,000 ACA marketplace policies covering 760,000 people, citing suspected fraud. The White House made the move public Sept. 22, saying brokers enrolled many without their knowledge and some enrollees may not exist; since then, CMS has reinstated a small number of people whose coverage was wrongly canceled and cut subsidies for 189,000 enrollees with duplicate or deceased coverage, saving $738 million.
Updated Oct 15
As of October 2026: Approved NTAP for Bayesian's sepsis monitor in FY 2027 Final Rule
Since October 1, 2026, hospitals using Bayesian Health's continuous AI sepsis monitor can bill Medicare for an extra payment of up to $61.84 per eligible discharge. The Centers for Medicare and Medicaid Services (CMS) approved the add-on payment in its FY 2027 Inpatient Prospective Payment System Final Rule.
Updated Oct 6
As of September 2026: Administers the ACCESS Model, Medicare, and Medicaid
Half of people with chronic conditions skip their treatment plans, and health plans have never closed that gap at scale. On September 16, RadiantGraph launched Care Guidance Agents to change that: AI voice agents that call Medicare patients between visits with coaching, adherence reminders, and preventive care prompts.
Updated Sep 17
As of August 2026: Covers tests only after symptoms appear; ASAP Act pending
Alzheimer's diagnosis used to require a $5,000 brain scan or a painful spinal tap. As of August 2026, the FDA has cleared four blood tests for the disease, from Roche's Elecsys pTau217 to C2N's PrecivityAD2, approved for adults as young as 40.
Updated Aug 25
As of May 2026: Issuing proposed procedural notice; TCET pathway paused for new candidates
For nearly a decade, medical device makers have faced the same bottleneck: the FDA clears a breakthrough device, and then Medicare spends another year or more deciding whether to pay for it. On April 23, 2026, the two agencies jointly announced the Regulatory Alignment for Predictable and Immediate Device (RAPID) pathway — it cuts that timeline to as little as two months. They simultaneously paused the existing Transitional Coverage for Emerging Technologies (TCET) program for new applicants, consolidating all breakthrough-device coverage work under RAPID.
Updated May 31
As of May 2026: Source of baseline spending projections and historical data
For decades, American health care spending grew faster than the economy. Government actuaries projected in 2010 that it would hit 21.2 percent of GDP by 2024 (about $6.3 trillion), but actual spending came in at 18%, roughly $977 billion less.
As of May 2026: Administering BALANCE model to expand GLP-1 access
Medicare has been banned from covering weight loss drugs since 2003. CMS launched BALANCE in December 2025, a voluntary model offering $50-per-month Ozempic and Wegovy access for 10% of Medicare enrollees starting July 2026.
Updated May 16
As of May 2026: Linked to a new CBD access pilot described alongside the executive order
Trump's executive order instructing DOJ to fast-track marijuana's move to Schedule III immediately triggered a familiar split. Public health and industry groups cheered the potential research and tax impacts, while House Republicans organized opposition, urging Trump to keep marijuana in Schedule I.
Updated May 15
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