The Centers for Medicare and Medicaid Services (CMS) finalized the 2027 physician fee schedule and hospital outpatient payment rules, Democrats won control of both chambers of Congress, and CMS said it will appeal the court ruling on Medicaid work requirement exemptions.
Voters choose the next Congress on Nov. 3, a federal judge struck down the Centers for Medicare and Medicaid Services’ medical frailty definition two months before Medicaid work requirements begin, and the Labor Department finalized a rule requiring pharmacy benefit managers to disclose how they are paid.
HHS released a national kidney care plan that targets dialysis market concentration, doctors and hospitals told FDA that developers should answer for generative AI device safety, and Senate Democrats warned that Medicaid eligibility systems are not ready for January work requirements.
CMS proposed new guardrails for pharmacy benefit managers and Medicare Advantage directories, the administration tightened Affordable Care Act subsidies, and a bipartisan House bill would delay the 340B rebate pilot for two years.
Cardiologists welcomed CMS’s new TAVR coverage rules while watching for self-referral, hospitals sued to stop the 340B rebate pilot, and CMS named the 2,217 hospitals entering mandatory joint replacement payment in 2028.
CMS canceled marketplace coverage for more than 760,000 people and froze new broker registrations, the White House dropped its plan for political review of NIH grants, and FDA advisers backed the first multicancer blood test.
The White House moved toward a veto over NIH grants this week, and new records showed how hastily Medicare launched its AI prior-authorization pilot.
Medicare rewrote the coverage standard for TAVR this week and quietly opened a second one for aortic regurgitation.
Comment season closed on the 2027 payment rules and hospitals answered on every front at once, medical societies wrote their own vaccine schedule, and Edwards’ size-adjustable pulmonary valve reached its first American patient.
HHS opened a comment period on whether vaccines should still be routinely recommended, CMS put its RAPID device coverage pathway out for comment and paused TCET for new candidates, and No Surprises Act arbitration passed $22 billion in cost.
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