CMS has finalized a 2.6% payment increase for inpatient services, boosted DSH payments, established new interoperability rules for prior authorization, and confirmed the launch of a controversial ...

In 2026, federal policy changes are reshaping prior authorization by requiring faster insurer responses, expanded drug coverage rules, and public reporting of approval and denial rates. Medicare ...

Recently, the Centers for Medicare & Medicaid Services (CMS) issued all the fiscal year (FY) 2026 Medicare final regulations for different facility types: hospice facilities, inpatient psychiatric ...

A new proposed rule from the Centers for Medicare and Medicaid Services would reduce the required response time to Medicare Advantage prior authorization requests for medications to 24 hours and ...

CMS has proposed a 2026 rule expanding prior authorization reforms to include drugs under both medical and pharmacy benefits, introducing electronic workflows, faster decision timelines, and greater ...

Availity®, the nation’s largest health information network, reinforced its preparedness for the Centers for Medicare and Medicaid Interoperability and Prior Authorization Final Rule (CMS-0057-F) and ...

A new CMS final rule increases IPPS payment rates by 2.6% for 2026 and finalizes several key policy changes, including the launch of a mandatory bundled payment model, new e-prescribing standards, and ...

Health data company Smile Digital Health and MCG Health are partnering in a move that will help payers meet the requirements of the Centers for Medicare and Medicaid Services Interoperability and ...

Healthcare and technology groups want Medicare Advantage plans included in the Centers for Medicare and Medicaid Services' proposed rule to expand access to health information and improve the prior ...

McDermott+ is pleased to bring you Regs & Eggs, a weekly Regulatory Affairs blog by Jeffrey Davis. November 4, 2025 – Trick or treat! On Halloween evening, the Centers for Medicare & Medicaid Services ...