Fosters Innovation for the Medicare Drug Price Negotiation Program – A new proposal from the CMS would establish a permanent framework for the Medicare Drug Price Negotiation Program, creating a more transparent and sustainable process for lowering drug costs for millions of Medicare beneficiaries.
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NOW on Demand Tell Me Where IT Hurts episode with host Dr. Jay Anders and his guest Kimberly Brandt, Chief Operating Officer and Deputy Administrator at CMS. They discuss slow value-based care adoption in Medicare, CMS’s data quality push through FHIR APIs and USCDI, and how AI will help flag fraud across millions of daily claims.
The Accountable Care Prospective Trend (ACPT) in the Medicare Shared Savings Program (MSSP) could cost accountable care clinicians more than $700 million in lost shared savings for care delivered in 2025. These reductions are the result of inaccurate forecasting embedded directly into MSSP benchmarks.
The 2026 Quality Payment Program (QPP) exception applications are now available through December 31, 2026, at 8 p.m. ET. There are 2 types of exception applications that allow participants to indicate why they can’t report data for one or more Merit-based Incentive Payment System (MIPS) performance categories.
By Chris Kenyon – The Centers for Medicare & Medicaid Services Interoperability and Prior Authorization Final Rule (CMS 0057 F) is often discussed as a health plan problem to solve. Are plans compliant? Are the APIs live? Is the data finally reliable? Those are fair questions, but they’re not the only questions providers should be asking.
The Centers for Medicare & Medicaid Services, through its Health Tech Ecosystem, is advancing its electronic prior authorization efforts through a newly established Electronic Prior Authorization Acceleration initiative to address key challenges and drive solutions ahead of 2027 requirements.
By Sarah Jane Tribble – Tory Starr is worried about the people who get medical care at Open Door Community Health Centers along California’s North Coast. “They’re the folks that work at restaurants. They’re the teacher’s aides,” said Starr, a registered nurse who became Open Door’s chief executive more than six years ago. Those patients, he said, are “really the heart and soul of rural America.”
Starts July 14th – This virtual collaborative experience will bring together health care interoperability leaders, implementers, and innovators for three days of hands-on testing, shared learning, and alignment on how emerging CMS policies and FHIR-based solutions are taking shape in real-world systems.
NOW on-demand, Value-Based Care Insights host Daniel J. Marino speaks with healthcare strategist Heather Flynn Kearney about what organizations are experiencing during the early stages of this mandatory model.