Social Media Ideas for Centers For Medicare And Medicaid Services

Trump admin blocks over $1.6B in potentially fraudulent Medicare lab payments: CMS

The CMS Fraud Defense Operations Center has also accounted for more than $371 million in Medicare suspended payments involving 267 providers and suppliers since Jan. 1, the agency...

Modernizing Medicare Advantage for the Next Generation of Seniors

The Centers for Medicare & Medicaid Services (CMS) took constructive steps in its 2027 final rule and rate announcement, particularly on payment integrity and quality measureme...

CMS Defers $1 Billion in Medicaid Payments—and Gains New Power to Exclude Providers

CMS Modernizes Medicare Coverage for TAVR

On September 10, 2026, the Centers for Medicare and Medicaid Services (“CMS”) issued a Decision Memorandum, finalizing significant updates to Medicare’s National Coverage Determina...

Centene chases $448M over Star Rating rules a court already killed

A court killed the rules. CMS kept using them. Now Centene says it cost half a billion

More Than a Billing Requirement: CMS Turns Medicare Enrollment into a Program-Integrity Tool

Key Updates CMS has proposed a significant expansion of its Medicare provider enrollment and program-integrity authorities through the Calendar Year 2027 Home Health Prospective P...

What CMS-0057-F and WISeR Change for Prior Authorization — and What Stays Manual

  When high-growth specialty practices look to reduce administrative burnout and accelerate patient care, deploying professional healthcare prior authorization services […] Magella...

CMS takes aim at duplicative ACA, Medicaid enrollments

The Trump administration has put a focus on rooting out fraud, waste and abuse, and on Wednesday, regulators offered a look at progress to date in those efforts.

ACCESS to Better Care- Things to Know About CMS’s ACCESS Innovation Model

Medicare Policy Shouldn’t Be Made in the Shadows

Medicare policy should be transparent and include appropriate notice and stakeholder input. And when a contractor gets it wrong, there should be a clear and rapid way to stop the h...

Fierce Healthcare Regulatory Recap: CMS releases 2027 MA star ratings; HHS awards $28M for falls prevention

The latest news from CMS, HHS and more across Washington, D.C.

Trump Admin Blocks $1.6 Billion in Potentially Fraudulent Medicare Lab Bills

By Naveen Athrappully Enforcement actions carried out by the Centers for Medicare & Medicaid Services (CMS) have stopped over $1.6 billion in potentially improper Medicare lab...

Ohio Department of Medicaid Proposes New Provider Suspension Rules as Centers for Medicare & Medicaid Services Escal...

CMS extends ACCESS model to more chronic conditions as agency officials eye cross-payer alignment

The Trump administration is rapidly expanding its 10-year ACCESS Model, a value-based payment program that reimburses digital health companies based on patient outcomes rather than...

CMS: About 71% of MAPD plan enrollees in coverage with four or more stars for 2027

The Trump administration has released the 2027 Medicare Advantage star ratings, with many enrollees in plans that earned at least four stars.

CMS puts more pressure on DME suppliers as part of anti-fraud push

The Trump administration is cracking down further on durable medical equipment suppliers as part of its broader push to root out fraud.

Leading ACCESS Model Participants

The CMS Advancing Chronic Care with Effective Scalable Solutions (ACCESS) Model went into effect on July 5. The 10-year, voluntary model aims to bring “technology-supported care” o...

CMS Seeks Industry Input on Fraud Defense Contracting Model

CMS is seeking industry recommendations on restructuring fraud defense contracts to improve Medicare fraud detection and prevention. The post CMS Seeks Industry Input on Fraud Defe...

Client Alert: Centers for Medicare & Medicaid Services 2027 Physician Fee Schedule Proposed Rule Would Upend Third-P...

CMS Broadens ACCESS Model to New Chronic Conditions

CMS will expand its ACCESS model starting in spring 2027 to cover heart failure, COPD, substance use disorders and tobacco cessation. The outcomes-based payment model, which launch...

CMS to cancel ACA coverage for 760K, crack down on brokers in latest anti-fraud push

The Trump administration plans to cancel enrollment in Affordable Care Act plans for more than 760,000 people as part of its crackdown on fraud, waste and abuse.

CMS's Hemp CBD Program Has A Physician Problem - MMJ Appeal Pending

In a recent interview Vantage Hemp's Chief Medical Officer says healthcare needs standardized, reproducible products and controlled clinical trials - as CMS carries its cannabinoid...

Four Is A Trend: Lessons For Medicare Advantage Diagnosis Coding Programs To Take From Recent FCA Settlements

CMS to Publish Medicaid AI Fraud Pilot Results, Expand Provider Exclusions

Kimberly Brandt says new HHS exclusion authority could quadruple provider suspensions as CMS reports $41.9B in fiscal 2025 savings. The post CMS to Publish Medicaid AI Fraud Pilot...