The week belonged to CMS: the CY2027 Physician Fee Schedule lands with a pay cut, an ACO overhaul, and a surprise remote-monitoring vendor ban, while the Medicaid work-requirement fight moves to court and the Senate grills Trump’s CDC and ASPR nominees over vaccines.
A light news week defined by new HHS activity under RFK Jr., fresh Medicare ACO data, and a Senate rattled by the death of Sen. Lindsey Graham and Sen. Mitch McConnell’s month-long absence.
This week: CMS’s draft 2027 outpatient rule takes aim at 340B and site-neutral pay, Medicare’s GLP-1 coverage era begins, and the Medicaid work-requirement fight lands in court.
This week: the 340B drug discount program faces a reckoning from every direction — Eli Lilly’s hospital cutoffs, a Cassidy overhaul bill, litigation over the patient definition, and hospital associations calling for federal intervention, all arriving in the same week.
CMS proposed the most significant expansion of Medicare TAVR coverage since the program launched, moving to extend access to asymptomatic patients and revise the volume requirements that have governed structural heart programs since 2012.
A week defined by the Medicare Advantage prior authorization reckoning, the CMS drug negotiation permanence push, and a concentrated burst of TAVR clinical evidence from JACC:CI.
House subcommittees unite on bipartisan reform push after hearing reveals widespread insurance company abuses
This issue brief addresses the topic of global payments for surgeons under the Medicare physician fee schedule (PFS): what they are, how they work (or don’t work) and why CMS seems so intent on doing away with them.
The Fourth of July can be counted on for two things: fireworks, and Medicare payment rules, the defining documents that sort DC health policy folk into two camps. On one side, there are the Hill staffers and lobbyists who are trying to strategically plot a path through the appropriations quagmire to get to August recess. Then there are the regulatory staff whose year has just started.
A few weeks ago, we reported that the publication of the Inpatient Prospective Payment System (IPPS) proposed rule, and specifically CMS’s big reveal of its mandatory Transforming Episode Accountability Model (TEAM) payment proposal, would awaken some of the physician payment policy wonks from a briefer than usual slumber. These past few weeks have shown signs of life, even in some unexpected places.
Savage Health Policy
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