Regulatory Issues


CMS Star Ratings: Keeping up with the 2026 Final Rule

By Marge Ciancetta – Among the most impactful changes released by CMS each year in the Medicare Advantage and Part D Final Rule are adjustments to the Star Ratings program. As a result of the most recently finalized changes, CMS projects a 0.69% decline in overall quality bonus payments for 2026.





Living HHS Open Data Plan Published

The U.S. Department of Health and Human Services announced the publication of its Living HHS Open Data Plan and the rollout of a refreshed HealthData.gov website marking a transformative milestone in the Department’s commitment to transparency, innovation, and data-driven decision-making.


ASTP/ONC’s HTI-4 Final Rule

By Tom Keane & Steven Posnack – ASTP/ONC released a final rule enabling the use of certified EHRs to submit prior authorizations, select drugs consistent with a patient’s insurance coverage, and exchange electronic prescription information with pharmacies and insurance plans.


Making the Most of a MIPS Situation

By Renee Freyer – Like any large program, MIPS evokes a range of opinions and perceptions, even misconceptions. MIPS was designed to use both a carrot and stick approach to encourage medical practices to provide higher quality care at a lower price.