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.
I’m so excited to share my recent conversation with Cancer Fashionista, Melissa Berry, on her podcast, Dear Cancer, I’m Beautiful.
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