Proposed Changes to the Medicare Diabetes Prevention Program
CMS proposed changes will expand reach of the Medicare Diabetes Prevention Program (MDPP) to achieve MAHA goals. Deadline to comment is 9/12/2025.
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A Closer Look at the HTI-4 Final Rule
By Mary Griskewicz – At its core, HTI-4 is about making prescribing and medication access more real-time, transparent, and aligned with patient needs. It updates health IT certification criteria in three key areas: electronic prescribing, real-time prescription benefit (RTPB), and electronic prior authorization (ePA).
CMS Proposes Physician Payment Rule to Significantly Cut Spending Waste
The calendar year 2026 Medicare Physician Fee Schedule proposed rule would advance primary care management through new quality measures, reduce waste and unnecessary use of skin substitutes, and introduce a new payment model focused on improving care for chronic disease management.
Securing Industry Pledge to Fix Broken Prior Authorization System
HHS Secretary Kennedy and CMS Administrator Oz press conference on securing industry pledges to fix the broken Prior Authorization System. They met with insurance leaders of nearly 80% of covered Americans.
CMS Seeks Public Input on Improving Technology to Empower Medicare Beneficiaries
The goal is to unlock the power of modern technology to help seniors and their families take control of their health and well-being, manage chronic conditions, and access care more efficiently.
100 Days of Health Policy Upheaval
From KFF Health News Network – Their latest podcast, What the Health, Members of Congress are back in Washington, and Republicans are facing hard decisions on how to reduce Medicaid spending, even as new polling shows that would be unpopular among their voters.
Upcoming CMS Deadlines
The following is communication from the Centers for Medicare & Medicaid Services (CMS) on upcoming deadlines.
Talent Tuesday: Montana Examines Ways To Ease Health Care Workforce Shortages
By Sue O’Connell – Mark Nay’s first client had lost the van she was living in and was struggling with substance use and medical conditions that had led to multiple emergency room visits. Nay helped her apply for Medicaid and food assistance and obtain copies of her birth certificate and other identification documents needed to apply for housing assistance.
Rural Hospitals Question Whether They Can Afford Medicare Advantage Contracts
By Arielle Zionts – Rural hospital leaders are questioning whether they can continue to afford to do business with Medicare Advantage companies, and some say the only way to maintain services and protect patients is to end their contracts with the private insurers.