On January 26, 2026, CMS released the Advance Notice of Methodological Changes for Calendar Year (“CY”) 2027 for Medicare Advantage (“MA”) Capitation Rate and Part C and Part D Payment Policies (the “Advance Notice”). In the...more
3/6/2026
/ Centers for Medicare & Medicaid Services (CMS) ,
Fee-for-Service ,
Health Insurance ,
Healthcare ,
Inflation Reduction Act (IRA) ,
Medicare ,
Medicare Advantage ,
Medicare Part D ,
PACE ,
Payment Systems ,
Prescription Drugs ,
Proposed Rules ,
Risk Adjustment Formula
On November 25, 2025, CMS released the Contract Year (“CY”) 2027 Medicare Advantage (“MA”) and Part D proposed rule (the “Proposed Rule”). The Proposed Rule would make significant changes to the MA and Part D programs,...more
12/3/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Drug Pricing ,
Enrollment ,
Health Insurance ,
Inflation Reduction Act (IRA) ,
Medicare Advantage ,
Medicare Part D ,
Opioid ,
Pharmaceutical Industry ,
Prescription Drug Coverage ,
Prescription Drugs ,
Proposed Rules ,
Regulatory Reform ,
Risk Adjustment Formula ,
Star Ratings
The Centers for Medicare & Medicaid Services (“CMS”) recently finalized a rule establishing the new Ambulatory Specialty Model (“ASM”)— a mandatory value-based payment model that could apply to nearly one-quarter of all...more
11/24/2025
/ ACOs ,
Alternative Payment Models (APM) ,
Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
Health Care Providers ,
Healthcare ,
Medicare ,
Medicare Part B ,
MIPS ,
Physician Fee Schedule ,
Physicians ,
Reporting Requirements ,
Value-Based Payments