A new Trump executive order sets the stage for lower 340B payments
Hospitals can anticipate a regulatory effort to lower the Medicare payments they receive for purchases of Part B drugs through the 340B Drug Pricing Program. President Donald Trump on April 15 signed a wide-ranging executive order on drug costs, and one of the provisions directs HHS to conduct a survey of hospital acquisition costs for…
Medicare’s FY26 inpatient hospital proposed rule includes a restrained payment update
The Trump administration’s first set of Medicare proposals establishing inpatient payment rates continued what hospital advocates describe as a long-term trend in which the annual update is lacking. A 3.2% increase in the market basket would be reduced by a 0.8% statutory productivity adjustment, according to the newly released FY26 proposed rule. Hospitals that meet…
How the 340B remedy payments will affect upcoming Medicare Advantage payment rates
Hospital advocates found reason for concern in a narrow aspect of the Medicare Advantage (MA) final payment rate notice for 2026. With health plans lauding the average 5.06%, $25 billion revenue increase they’re projected to reap in the upcoming year, hospitals may wonder about adverse impacts from an applied reduction in CMS’s calculation of the…
Final 2026 rule for MA, Part D leaves out proposed GLP-1 drug coverage
The Trump administration’s final rule setting policy and technical changes for Medicare Advantage (MA) in 2026 did not carry forward a proposal regarding GLP-1 drug coverage, but key provider-focused provisions were retained. The rule, which is scheduled for formal publication April 15 and also sets 2026 Medicare Part D policies, excludes a Biden administration proposal…
Questions about Medicaid cuts are unresolved in latest budget reconciliation blueprint (updated)
Note: This article was updated April 10 with the latest news on steps forward in the reconciliation process and a rollback of a specific set of funding by CMS. As released this week, the Senate’s latest budget reconciliation blueprint provides few answers about the impact a final bill could have on federal healthcare spending, in…
HHS restructures for the DOGE era
A massive HHS restructuring announced March 27 could have an indirect impact on providers. Secretary Robert F. Kennedy Jr. announced HHS would reduce its workforce by 10,000 FTEs, part of a 25% downsizing from 82,000 to 62,000, with previously announced early retirements and buyouts also factoring into the count. The department’s agencies will be pared…
Dr. Oz and CMS, plus HFMA’s new Fast Finance newsletter
Nick Hut and Shawn Stack discuss the confirmation hearing of Mehmet Oz as CMS administrator. Also in this episode, HFMA’s Brad Dennison and Rich Daly talk about the new Fast Finance newsletter. To sign up for the newsletter, email Brad Dennison at bdennison@hfma.org.
Hospital financial metrics suggest need for added Medicare payment, MedPAC says
Hospital metrics suggest FY26 Medicare payment should increase by more than what’s provided in the statutory formula, according to a formal recommendation by the Medicare Payment and Advisory Commission (MedPAC). Beneficiary access to care appeared to be strong in 2023, the latest year for which data was available, but quality indicators were mixed, according to…
Trump administration keeps up the fight on 340B, Inflation Reduction Act concerns
The issue of drug pricing is proving to be an area of harmony and continuity between the Trump and Biden administrations, at least for now. In recent days, the Trump administration moved to defend the Biden administration’s stance in opposition to drug manufacturers that are looking to offer 340B Drug Pricing Program discounts through a…
Trump administration charts a new course at the Center for Medicare & Medicaid Innovation
The Trump administration has started to streamline the portfolio of alternative payment models sponsored by the Center for Medicare & Medicaid Innovation (CMMI), recently announcing the early expiration of four models. CMS said the decision resulted from an assessment of whether the models could meet statutory criteria to be expanded into the full Medicare program.…