Agency Promises More Frequent Drug/Device HCPCS Code Update Opportunities, Bars MACs from Adopting New Blanket Noncoverage Policies without Evidence Review

The Centers for Medicare & Medicaid Services (CMS) recently announced that it has several "prevailing concerns" regarding the accuracy of the 2017 Merit-Based Incentive Payment System

The Centers for Medicare & Medicaid Services has confirmed that it expects to have a "temporary gap" in the DMEPOS competitive bidding program (CBP) during calendar years 2010-2020.

In May, we discussed the final rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the "Final Rule")...

The Centers for Medicare and Medicaid Services recently finalized its proposed "market stabilization rule" (Final Rule). The Final Rule is largely consistent with the February 17 proposed rule (Proposed Rule).

Some Medicare payment models are slated for early termination and even termination prior to actual launch.

The Centers for Medicare & Medicaid Services has imposed an immediate six-month nationwide moratorium on new Medicare enrollment for hospices and home health agencies, marking an unprecedented federal intervention in healthcare provider enrollment. This aggressive enforcement action, coordinated with the Vice President's Anti-Fraud Task Force, signals a dramatic shift in how the government intends to combat suspected fraud in these sectors.

On December 5, the Centers for Medicare & Medicaid Services (CMS) finalized a rule (the Final Rule)1 that expands its program integrity and provider enrollment authorities.

The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule that would extend and modify the Comprehensive Care for Joint Replacement (CJR) Model...

The Centers for Medicare & Medicaid Services (CMS) has issued its final Medicare physician fee schedule (MPFS) for calendar year (CY) 2017.

Effective January 1, 2026, Medicare providers and suppliers will be subject to a swath of new policies related to enrollment with the Centers for Medicare & Medicaid Services (CMS).

Last month, we highlighted a few of the changes CMS proposes in Parts I and II of the Advance Notice and Draft Call Letter. Here, we take a look at CMS's next steps to combat opioid misuse.

The Centers for Medicare & Medicaid Services (CMS) released the Hospital Outpatient Prospective Payment System: Remedy for 340B-Acquired Drugs Purchased in Cost Years 2018-2022 Proposed Rule on July 7, 2023.

The proposed rule addresses numerous aspects of Medicare Part B and other CMS program policies.

On November 6, 2025, the Centers for Medicare & Medicaid Services (CMS), through its Center for Medicare and Medicaid Innovation, announced the upcoming...

On May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) announced significant changes in its risk adjustment data validation (RADV) audits.

For the last of our series on the 2016 Draft Call Letter, we focus on the provisions impacting plans serving Medicare-Medicaid, or dual eligible, enrollees.

The Centers for Medicare & Medicaid Services (CMS) has published its final Medicare physician fee schedule (PFS) rule for CY 2018.

The actual update for individual procedures can vary dramatically, however, based on changes in relative weights and other policies in the proposed rule.

CMS has released a complex and controversial plan – the Part B Drug Payment Model — to test new Medicare payment methods for certain Part B drugs to determine whether alternative payment designs will reduce Medicare expenditures.