Site-neutral payment emerges as Medicaid savings tool in GOP reconciliation plan
Congressional Republicans are touting healthcare competition and consumer choice, along with expanded site-neutral payment, in a preliminary framework for a second reconciliation bill. The Republican Study Committee in the U.S. House of Representatives put forth ideas geared toward healthcare policies, home prices, energy prices, credits for stay-at-home parents and more, along with proposals to cut…
Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model Summary
HFMA presents a detailed summary of CMMI’s Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model.
Trump releases healthcare plan that would have major implications for the industry
President Donald Trump’s newly released healthcare plan would promote transparency and consumerism and usher in significant changes to coverage, with some stakeholders saying more information is necessary to make a valid assessment of the pros and cons. Touted as a push to address wider issues with affordability, the plan requires Congress to fill in the…
No Surprises Act IDR enforcement uncertain after Supreme Court declines review
Inaction by the Supreme Court this week raised new questions about enforcement of the No Surprises Act’s independent dispute resolution (IDR) process. The high court denied a petition by two air ambulance companies to review a circuit court’s 2025 decision that IDR awards are not enforceable in federal court. That opinion by the U.S. Court…
Hospital-insurer contract disputes could intensify as cost pressures persist
Relationships between hospitals and health insurers are expected to undergo further strain this year, according to analysts with a leading credit ratings agency. “Providers are still dealing with rising operating costs, labor supplies and infrastructure that outpace what insurers have been willing to pay in recent years,” said Bradley Ellis, senior director for the U.S.…
Affordable Care Act subsidy extension progresses, but many questions persist (updated Jan. 13)
Note: A section of this article has been updated with the latest ACA enrollment numbers for 2026 Momentum in Congress is building toward an extension of the enhanced subsidies for buying Affordable Care Act (ACA) marketplace coverage, although successful passage would not negate the ongoing uncertainty. On Jan. 8, the House of Representatives passed a…
DMEPOS Fee Schedule Rate Comparison Tables for 2025 and 2026
HFMA presents a spreadsheet comparing calendar year 2026 to 2025 payment rates for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) fee schedule.
CMMI payment models signal broader Medicare reimbursement shifts
CMS’s Center for Medicare & Medicaid Innovation (CMMI) was busy during the last two months of 2025, announcing a number of new models designed to improve healthcare and keep costs in check. Some address specific priorities of President Donald Trump or HHS Secretary Robert F. Kennedy Jr. New models scheduled for implementation over the next…
340B rebate model no longer beginning Jan. 1 after court issues preliminary injunction (updated Jan. 12)
Note: The last section of this article was updated with news that HHS is stepping back from its appeal of the litigation. A federal court stopped implementation of a 340B Drug Pricing Program rebate model that had drawn fierce opposition from providers. The Dec. 29 preliminary injunction by a Trump-appointed judge at the U.S. District…
Voices in Healthcare Finance: Looking ahead to 2026
Nick Hut and Shawn Stack discuss what’s coming in healthcare in 2026 with Katie Gilfillan from HFMA’s policy team.