Centers for Medicare & Medicaid Services

WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) has proposed a 0.09% increase in Medicare Advantage (MA) payments for calendar year 2027.

If finalized, the proposed policies are projected to result in a net average year-over-year payment increase of 0.09%, or over $700 million in MA payments to plans in CY 2027. 

WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) has released a new online complaint form for providers to submit grievances related to Medicare Advantage (MA) plans.

WASHINGTON—Earlier this week, the Centers for Medicare & Medicaid Services (CMS) updated several lists that cover durable medical equipment (DME) reimbursement authorization. The three lists updated were the required face-to-face and written order prior to delivery list (Required F2F/WOPD), the required prior authorization list and the master list. 

WASHINGTON—The Centers for Medicare & Medicaid Services announced it is expanding the provisional period of enhanced oversight (PPEO) for newly enrolled hospices in Ohio and Georgia. This expansion adds to the list of states that have implemented the PPEO including Arizona, California, Nevada and Texas.

OWINGS MILLS, Maryland—The Centers for Medicare & Medicaid Services (CMS) has reinstated the Board of Certification/Accreditation (BOC) as an approved accrediting organization (AO) for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) until further notice.

WASHINGTON—The Medicare Payment Advisory Commission (MedPAC) released a draft report recommending that Congress reduce the Medicare base payment rate for home health care services for calendar year 2027 by 7%.

Along with the occasional aches and pains, growing older can bring surprise setbacks and serious diseases. Longtime relationships with doctors people trust often make even bad news more tolerable. Losing that support — especially during a health crisis — can be terrifying. That’s why little-known federal requirements are supposed to protect people with privately run Medicare Advantage coverage when contract disputes lead their health care providers and insurers to part ways.

OVERLAND PARK, Kansas—Netsmart, a provider of health care IT for post-acute and human services providers, announced the launch of AlphaCoding, an augmented intelligence (AI) solution designed to help transform clinical coding by driving accuracy, efficiency and compliance. 

WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) officially approved five durable medical equipment, prosthetics and orthotics supplies (DMEPOS)-related audit projects under the new Medicare Recovery Audit Contractor (RAC), Cotiviti GOV Services, LLC, marking the contractor’s first time overseeing Medicare DMEPOS RAC reviews. 

The new projects include:

BURKBURNETT, Texas—HomeWell Care Services, a non-medical in-home care franchises, has announced a national strategic partnership with PocketRN, a virtual nursing provider, to expand its dementia care support for seniors and their families as part of the Centers for Medicare & Medicaid Services’s (CMS) Guiding an Improved Dementia Experience (GUIDE) Model.

WASHINGTON—A national poll by Fabrizio Ward, commissioned by the National Alliance for Care at Home (the Alliance), found that seven in 10 Americans oppose the Centers for Medicare & Medicaid Services’ (CMS) 2026 Medicare home health proposed rule, which is expected to cut Medicare home health funding by an additional 9%, or $1.1 billion, next year.

WASHINGTON—Representatives Kevin Hern (OK-01) and Terri Sewell (AL-07) introduced the Home Health Stabilization Act of 2025 (HR 7027). The legislation aims to ensure patients have access to rehabilitative care by pausing the payment cuts proposed in the Centers for Medicare & Medicaid Services’ (CMS) Calendar Year 2026 Home Health Prospective Payment System proposed rule. The legislation also looks to create a more sustainable payment system for Medicare Home Health Agencies (HHAs).

WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) is retracting its recent guidance regarding Outcome and Assessment Information Set (OASIS) data collection, according to the National Alliance for Care at Home.

FORT SMITH, Arkansas—Mercy Home Health-Fort Smith has been awarded a five-star rating from the Centers for Medicare & Medicaid Services (CMS) for both Quality of Patient Care and Patient Survey Satisfaction, making it the only home health provider in Arkansas to receive five stars in both categories.

WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) announced a new prior authorization pilot program that will require recipients of Medicare to receive prior approval before obtaining access to certain medical services. 

WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) launched an oversight initiative to ensure that enrollees in Medicaid and the Children’s Health Insurance Program (CHIP) are United States citizens, U.S. nationals or have a satisfactory immigration status.