CMS
CMS Proposed Outpatient Payment Rule Threatens Essential Funding, ASHP Argues
CMS has released one of its largest annual proposed payment rules, the Hospital Outpatient Prospective Payment ...
AUGUST 14, 2025
CMS Updates COVID-19 Vaccination Reporting Requirements
Two COVID-19 vaccination reporting requirements have been removed by the CMS regarding Medicare payment ...
AUGUST 7, 2025
Navigating the Next Wave of Pharmacy Audits
Audits by PBMs, state boards of pharmacy and CMS likely rank among the biggest stressors for hospital pharmacies, ...
APRIL 11, 2025
CMS Fee Schedule Proposes New Add-on Code for ID Docs
CMS released its 2025 Medicare Physician Fee Schedule proposed rule, which included a new “add-on” code ...
JULY 16, 2024
CMS Incentivizes Payor Health Disparity Performance
Medicare Advantage and other health plans are starting to pay more attention to medication adherence, social ...
JUNE 24, 2024
New CMS Rules Aim to Help Patients to Afford, and Stick to, Medications
CMS has released the final part 1 guidance for the new Medicare Prescription Payment Plan, part of President Joe ...
APRIL 19, 2024
New CMS Rules Streamline PAs but Exclude Drugs
CMS announced new rules for government-sponsored health insurance companies requiring them to invest in an ...
MARCH 12, 2024
AI May Not Be So Smart When Payors Use It To Deny Medical Claims
Concerns are growing about the increasing use of artificial intelligence to review—and in many cases ...
FEBRUARY 23, 2024
PBM Cuts, DIR Fees And Audits Add Dour Note to the New Year
Pharmacy benefit managers have responded to the new CMS rule requiring them to account for all ...
FEBRUARY 12, 2024
PBMs Implement Sweeping Reimbursement Cuts and Ramp Up Audits
Pharmacy benefit managers have responded to a new CMS rule requiring them to account for all ...
DECEMBER 26, 2023
Intermountain Scales HaH Heights Without a CMS Waiver
When COVID-19 first struck the United States in early 2020, the Centers for Medicare & Medicaid Services began ...
OCTOBER 12, 2023
Strengthening Caregiver Support Is Essential for Improving Dementia Care
CMS is launching the Guiding an Improved Dementia Experience (GUIDE) Model nationwide.
SEPTEMBER 26, 2023
