Medicare Physician 2026 Rate And Reforms
The Centers for Medicare & Medicaid Services (CMS) released its 2026 physician fee schedule on Monday evening, announcing an increase of 3.62% over the 2025 rate. The budget reconciliation bill increased rates for that year by 2.5%. The added amount was due to other changes in the rate-setting system. Physicians in alternative payment models will see an increase of 3.83%.
CMS also unveiled a series of rate and other reforms, including rewarding certain physicians for avoiding hospitalizations, coordinating better with primary care, and early intervention. CMS also proposed removing 10 quality measures that do not improve patient health outcomes and introduced five new ones, with an emphasis on preventive services and expanding Medicare diabetes prevention.
Additional articles: https://www.fiercehealthcare.com/regulatory/cms-proposes-36-pay-bump-docs-takes-aim-chronic-conditions-physician-fee-schedule and https://www.beckershospitalreview.com/finance/cms-pitches-2026-physician-pay-plan-with-2-conversion-factors-8-things-to-know/ and https://www.beckershospitalreview.com/finance/cms-proposes-2026-medicare-rule-6-notes/ and https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-medicare-physician-fee-schedule-pfs-proposed-rule-cms-1832-p and https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-medicare-physician-fee-schedule-proposed-rule-cms-1832-p-medicare-shared and https://www.cms.gov/newsroom/press-releases/cms-proposes-physician-payment-rule-significantly-cut-spending-waste-enhance-quality-measures-and
(Some articles may require a subscription.)
#cms #medicare #regulations #providers #physicians #acos
https://www.modernhealthcare.com/politics-regulation/mh-medicare-physician-pay-cms-2026
A Second Budget Bill Taking Shape
Rumors of a second budget reconciliation bill seem to be true and what may be in it is beginning to take shape. Rightists in the House want to enact deeper Medicaid cuts, including cutting reimbursement to expansion states.
In addition, House Budget Committee Chairman Jodey Arrington, R-TX, wants to enact site neutral payments in Medicare, saving $150 billion.
Health plans are reeling from the prospect of getting hit hard by the bill after a rough couple financial years. It will mean continuing retrenchment. I have a blog ready on this topic for Thursday.
Interestingly, a Harvard CAPS/Harris poll released Monday found 44 percent of respondents said they supported the Republicans’ major policy bill while another 44 percent said they didn’t support the legislation. A separate 12 percent said they were not sure.
Last, hospitals are already gearing up to stop many reductions. Because many of them (including work requirements and some provider tax changes) do not go into effect for some time, the lobbyists will seek repeals in future Congresses.
Additional articles: https://www.modernhealthcare.com/politics-regulation/mh-medicaid-medicare-cuts-budget-bill/ and https://www.reuters.com/legal/litigation/trumps-spending-bill-will-likely-boost-costs-insurers-shrink-medicaid-coverage-2025-07-14/ and https://thehill.com/homenews/campaign/5400372-trump-bill-divided-voters-poll/?tbref=hp and https://www.politico.com/news/2025/07/14/hospitals-megabill-medicaid-lobbying-00449450?nid=00000197-a74d-da70-a9ff-a75da4350000&nname=inside-congress&nrid=0000014e-f114-dd93-ad7f-f915e1160001
(Some articles may require a subscription.)
#budgetreconciliationbill #healthcare #coverage #medicaid #managedcare #aca #obamacare #siteneutral
https://kffhealthnews.org/news/article/trump-tax-spending-law-health-care-industry-lobbying/
Medical Debt Rule Set Aside
A federal judge in Texas reversed a Biden administration rule that wiped medical debt from credit reports. The judge said the Consumer Financial Protection Bureau (CFPB) exceeded its authority in issuing the rule.
#medicaldebt #healthcare #surprisebilling
https://thehill.com/homenews/administration/5398381-joe-biden-medical-debt-reporting-rule-scrapped
— Marc S. Ryan
