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The Latest Breaking News from CMS

Why the Era of Chart Mining in Medicare Advantage Is Coming to an End

Chart mining, the practice of sending coders into historical medical records to find diagnosis codes that were clinically present but never submitted to CMS, has been a cornerstone of Medicare Advantage risk adjustment for nearly two decades. Health plans hired vendors to process millions of charts annually. Coders identified diagnoses.…

inkl

The Hospice Fraud Crackdown: How Medicare Investigations Are Delaying Access for Some Patients

For families facing the emotional reality of end-of-life care, hospice services are supposed to provide comfort, dignity, and support during one of life’s most difficult...

Saving Advice

GLP-1 Coverage Update: How Medicare’s New Transitional Policies Could Lower Out-of-Pocket Costs for Weight-Loss Medications

For years, many seniors and retirees have faced a frustrating reality: popular GLP-1 medications like Wegovy and Zepbound could cost well over $1,000 per month...

Saving Advice

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CMS Energy Stock: Analyst Estimates & Ratings

While CMS Energy has lagged behind the broader market over the past year, Wall Street analysts maintain a moderately optimistic outlook about the stock’s prospects.

Barchart

What Changed in Remote Therapeutic Monitoring in 2026?

The Centers for Medicare & Medicaid Services completely rewired Remote Therapeutic Monitoring for physical therapists and healthcare systems. The biggest news is that CMS finalized lower data collection and management thresholds to bridge real-world clinical gaps for shorter duration monitoring. Historically, the rigid 16-day monitoring requirement caused widespread billing friction…

inkl

Projected 2027 IRMAA Brackets and Surcharges for Medicare Part B and D

Will you owe the Medicare IRMAA surcharge in 2027? Grab your 2025 tax return and check the projected brackets and surcharges for next year.

Kiplinger

CorMedix Eyes REZZAYO Expansion as DefenCath Reimbursement Shift Looms

CorMedix (NASDAQ:CRMD) CEO Joe said the company is preparing for several potential commercial and regulatory catalysts across its infectious disease and dialysis-related portfolio, including a possible expansion of REZZAYO into fungal infection prophylaxis and continued work to sustain DefenCath uti

MarketBeat

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Kyle Busch net worth: Will NASCAR Coca-Cola 600 be postponed or canceled?

Kyle Busch death: NASCAR champion was thought to have had a sinus cold While racing May 10 at Watkins Glen, Busch radioed his team requesting a “shot” from a doctor after he finished.

The Economic Times

Medicare Advantage Company Alignment Healthcare Shows Huge, Unusual Call Option Activity

Alignment Healthcare, a fast-growing Medicare Advantage company, had strong Q1 revenue and adjusted EBITDA results. That may be the underlying reason for the huge, unusual call option activity today.

Barchart

Dear England playwright praises local BBC radio for supporting first production

Graham appeared before the Culture, Media and Sport Committee (CMS) to discuss the issues facing the BBC.

Evening Standard

Medicare Negotiations Continue: 15 More Drugs Including Weight-Loss Treatments Could See Price Cuts in 2027

Prescription drug costs continue to be one of the biggest financial pressures facing retirees and older Americans. In fact, many Medicare beneficiaries (around 21%) spend...

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GRAIL Says Galleri Demand Is Rising as NHS Talks, FDA Review Move Ahead

GRAIL (NASDAQ:GRAL) said demand for its Galleri multi-cancer early detection test has continued to grow despite recent headlines related to its NHS study, according to comments made by Aaron, who identified himself during the discussion as the company’s CFO, at a Bank of America event. Aaron said t

MarketBeat

CMS’s New AI-Powered Prior Authorization System: Will It Speed Up Approvals or Deny Seniors Critical Care?

For years, seniors and doctors have complained that prior authorization delays can feel like a second illness layered on top of an existing medical problem....

Saving Advice

Weight-Loss Drugs Wegovy & Foundayo Get Medicare Coverage on July 1, 2026 — Find Out Who Qualifies

For years, many older Americans watched popular weight-loss drugs like Wegovy stay financially out of reach because Medicare would not cover medications prescribed mainly for...

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MarketBeat

DocGo Targets Profitability as It Pivots to Mobile Health, Medical Transport

DocGo (NASDAQ:DCGO) Chief Executive Officer Lee Bienstock outlined the company’s transition away from COVID-related, migrant and emergency-response programs and toward its “evergreen” medical transportation and mobile health businesses during a presentation at the 21st Annual Needham Technology, Med

Saving Advice

Medicare’s 72-Hour Decision Rule Begins Now: What Seniors Must Know About Faster Approvals and Denials

Millions of seniors enrolled in Medicare Advantage plans have spent years frustrated by delayed prior authorization decisions for medical care, scans, procedures, and treatments. Some...

The Mary Sue

Vance’s Medicare crackdown just froze billions in hospice care, but the scheme it uncovered is far darker than a simple billing scam

Vice President J.D. Vance’s Medicare fraud task force just froze billions in hospice care payments, slamming the brakes on new providers nationwide for the next six months. The move, announced on May 13, 2026, is the sharpest crackdown yet on what officials are calling a crisis of exploitation — one…

MarketBeat

AxoGen Says Nerve Repair Strategy Intact as Reimbursement Wins Gather Steam

AxoGen (NASDAQ:AXGN) President and CEO Michael Dale said the company’s growth strategy remains centered on developing the market for peripheral nerve repair, while recent reimbursement wins are expected to be positive but have not yet been quantified. Speaking during a company event, Dale said he w

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MarketBeat

PACS Group Q1 Earnings Call Highlights

PACS Group (NYSE:PACS) reported a strong start to 2026, with executives citing higher occupancy, improved skilled mix and continued progress integrating acquired facilities as drivers of first-quarter performance. On the company’s earnings call, Chairman and CEO Jason Murray said PACS entered the y

International Business Times UK

Trump Wages $1.3 Billion Medicaid War on California and Warns All States Face Total Funding Suspension

The Trump administration has withheld $1.3 billion in Medicaid payments to California and imposed a nationwide freeze on new Medicare provider enrolments, citing healthcare fraud concerns.

The Guardian - US

JD Vance threatens health funding to states that don’t comply with White House anti-fraud effort

Medicare has already paused hospice and home healthcare agency signups as potential fraud is investigated

MarketBeat

Sanuwave Health Q1 Earnings Call Highlights

Sanuwave Health (NASDAQ:SNWV) reported record first-quarter revenue and rising consumables utilization, while management said the advanced wound care market began to recover after a difficult start to the year tied to changes in reimbursement for skin substitutes. Chairman and CEO Morgan Frank said

The Independent UK

Trump administration freezes new Medicare enrollments for hospice and home health agencies

The Trump administration is expanding its fraud-busting initiative in federal health programs

Medical Daily

Healthcare Outsourcing Philippines: Why Agentic AI Demands Human Expertise, Not Replacement

Inside the $423+ Billion Global Healthcare Outsourcing Market: How Philippine Clinical Talent Is Solving the Crisis That Autonomous AI Cannot

MarketBeat

Nyxoah Q1 Earnings Call Highlights

Nyxoah (NASDAQ:NYXH) reported 13% sequential worldwide net revenue growth in the first quarter of 2026, driven primarily by continued adoption of its Genio system in the United States, where the company is in its second full quarter of commercialization. Chief Executive Officer Olivier Taelman said

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