In brief: Health care spending, prior auth list, fraud division

WASHINGTON – Health care spending in the U.S. reached $5.3 trillion and increased 7.2% in 2024, similar to 7.4% in 2023, as increased demand for health care influenced this two-year trend, according to a new article in the journal Health Affairs. 

Health care spending growth continued to outpace overall economic growth 

As a result, the health care share of the economy increased from 17.7% in 2023 to 18% in 2024. In 2024, the share of gross domestic product (GDP) devoted to health care was 18%, which was higher than the 2022 and 2023 shares of 17.6% and 17.7%, respectively. For 2023 and 2024, average health care spending growth of 7.3% per year was nearly 3 percentage points faster than during 2021–22. In comparison, GDP growth slowed significantly from the period 2021–22, averaging 6% per year in 2023–24. 

Medicare FFS spending experienced faster growth 

Medicare spending, which accounted for 21% of total national health care expenditures, reached $1.1 trillion in 2024, an increase of 7.8% after 9% growth in 2023. Although Medicare Advantage private plan spending slowed in 2024 (from 16.1% in 2023 to 9% in 2024) because of policy changes lowering benchmark payment rates, Medicare fee-for-service spending experienced faster growth in 2024, increasing 6.4% after growth of 2% in 2023. 

Medicare Advantage enrollment hits 50% of all enrollees 

Total Medicare enrollment grew 2.2% to 66.6 million in 2024, increasing at the same rate of growth as in 2023. Although experiencing faster spending growth in 2024, fee-for-service enrollment continued to decline (for the sixth year in a row), falling 1.4%. Medicare Advantage enrollment, in contrast, increased 6.1% in 2024 (compared with growth of 7.9% in 2023) to reach 33.4 million beneficiaries, or 50% of all Medicare enrollees (data not shown). Per enrollee, total Medicare spending grew 5.4% in 2024, a slower rate of growth than the increase of 6.7% in 2023, as a result of slower growth in Medicare Advantage spending. 

Medicaid spending slowed as enrollment declined 

In 2024, Medicaid spending reached $931.7 billion, accounting for 18% of total national health care expenditures. Although total Medicaid spending increased by 6.6% in 2024, this growth rate was slower than in previous years – down from 7.9% in 2023 and 9.7% in 2022. Medicaid enrollment declined by 8.6% (or 7.9 million) to 84.3 million in 2024. This decline occurred as states resumed eligibility redeterminations after the end of pandemic-era coverage provisions. 

But per-enrollee Medicaid spending surged 

Coinciding with declining Medicaid enrollment, per enrollee Medicaid spending surged by 16.6 % in 2024, which was a dramatic increase compared with the 6.5% rise in 2023. This acceleration was due to two primary factors: 

• Changes in enrollment composition resulted in a higher proportion of enrollees with complex medical conditions, greater health care needs and higher utilization rates, as most people no longer enrolled in the program were lower-cost children and adults. 
• Rising provider payment rates, along with growth in state-directed payments to providers through managed care organizations, contributed to higher per enrollee spending. 

The article also noted that Medicaid government administration costs increased by 19.8% in 2024 compared with 9.2% in 2023, most likely because of continued unwinding operations. 

Read the full article here. 

CMS updates several DMEPOS lists 

WASHINGTON – CMS has updated the  Required Face-to-Face and Written Order Prior to Delivery List, Required Prior Authorization List and Master List, AAHomecare has reported. 

Beginning April 13, 2026, items added to the Required F2F/WOPD List and Required Prior Authorization List will need to meet new requirements.  

Required F2F/WOPD List: 
Added the following items: 

• Stationary and portable oxygen systems (E0424, E0431, E0433, E0434, E0439) 
• Oxygen concentrators (E1390, E1391, E1392) 

Beginning April 13, these items will require a documented face-to-face encounter within six months prior to the written order. 
   
Required Prior Authorization List: 
Added the following items: 

• Orthoses (L0651, L1844, L1846, L1852, L1932) 
• Pneumatic compression devices (E0651, E0652) 

Beginning April 13, prior authorization will be implemented nationwide for the items listed. CMS will publish sub-regulatory guidance regarding the implementation of the items to the program. 
 
Master List (items that are eligible to be added to a Required List): 

• Continuous glucose monitor supplies (A4238, E2103) 
• Wound dressings (A6214, A6233) 
• Compression garments and accessories (A6583, A6593) 
• Respiratory and airway clearance devices (A7025, E0468, E0469) 
• Therapeutic electrical & neuromodulation devices (E0743, E0762) 
• Light therapy (E0691) 
• Power mobility accessories (E2377) 
• Orthotic and prosthetic additions (L1499, L2999, L5783, L5841) 
• Misc DME (E1399) 

Note: There is no immediate direct impact to suppliers for items being added to the Master List; inclusion simply means the items are eligible to be added to the F2F/WOPD Required List and/or Prior Authorization Required List in the future, says AAHomecare. 

White House launches new fraud division 

WASHINGTON – The White House has established a new Division for National Fraud Enforcement as part of the U.S. Department of Justice (DOJ). The assistant attorney general for this new division will be responsible for leading efforts to investigate, prosecute and remedy fraud targeting federal government programs and federally funded benefits, businesses, nonprofits and private citizens nationwide. “This role will oversee multi-district and multi-agency fraud investigations; provide advice, assistance and direction to the United States Attorneys’ Offices on fraud-related issues; and work closely with federal agencies and department components to identify, disrupt and dismantle organized and sophisticated fraud schemes across jurisdictions,” the administration states in a fact sheet. The new Assistant Attorney General will also: 

• Help develop and set national enforcement priorities and propose legislative and regulatory reforms as necessary to close systematic vulnerabilities and prevent future abuses. 
• Advise the Attorney General and Deputy Attorney General on issues involving significant, high-impact fraud investigations and prosecutions and related policy matters. 

The fact sheet also included steps the administration has taken to end fraud in Minnesota, including the FBI’s investigation into dozens of health care and home care providers in the state. 

CMS says 22.8M consumers have signed up for insurance through Marketplaces 

WASHINGTON - The Centers for Medicare & Medicaid Services (CMS) reports that 22.8 million consumers have signed up for individual market health insurance coverage through the Marketplaces since the start of the 2026 Marketplace Open Enrollment Period (OEP) on Nov. 1, 2025. This includes 15.6 million Marketplace plan selections in the 30 states using the HealthCare.gov platform for the 2026 plan year and 7.2 million plan selections in the 20 states and the District of Columbia with State-Based Exchanges (SBEs) that are using their own eligibility and enrollment platforms. Total nationwide plan selections include 2.8 million consumers who are new to the Marketplaces for 2026, and 20 million consumers who had active 2025 coverage and selected a plan for 2026 coverage or were automatically re-enrolled. 

Encore Healthcare earns HITRUST status for Nexus platform 

LIVINGSTON, Tenn. – Encore Healthcare has announced its Nexus platform has earned certified status by HITRUST for information security. HITRUST r2 Certification demonstrates that the company has met demanding regulatory compliance and industry-defined requirements and is appropriately managing risk. “As the stakes around data security and privacy continue to rise, our customers need partners they can truly trust,” said Keisha Harper, COO at Encore Healthcare. “By earning HITRUST r2 Certification, we’ve validated that our systems and processes meet some of the most demanding standards in health care—so our clients can move forward with confidence.” Encore Healthcare says this achievement places the company in an elite group of organizations worldwide that have earned this certification. By including federal and state regulations, standards and frameworks and incorporating a risk-based approach, the HITRUST Assurance Program helps companies address security and data protection challenges through a comprehensive and flexible framework of prescriptive and scalable security controls. 

Aeroflow Health participates in Michigan Medicaid contract 

ASHEVILLE, N.C. – Aeroflow Health has announced that it is participating as a contracted network provider for Northwood Inc. to provide Blue Cross Complete of Michigan with durable medical equipment (DME) for Medicaid members across the state. Medicaid members enrolled in Blue Cross Complete of Michigan now have streamlined access to a wide range of medical supplies through their insurance, including breast pumps, diapers, CPAPs and other essential products to support health and independence at home. Offering DME through Aeroflow Health’s end-to-end support model ensures these members receive quality equipment, benefit education and personalized patient support, the organizations say. “Our work centers around giving individuals equal opportunity to manage their health with confidence,” said Amanda Minimi, VP of health solution marketing and operations at Aeroflow Health. “For new and expecting mothers, maternity and breastfeeding supplies support healthier pregnancies and early childhood development. For families caring for children with special needs, access to incontinence supplies helps support comfort and care at home. Our goal remains to deliver care to those who need it most, and we’re excited to expand our work in Michigan with Blue Cross Complete of Michigan.” 

• Related: Aeroflow Health now provides DME to 400K enrolled in Medicaid in Hawaii. 

RESNA launches new innovation award as part of Developers Showcase 

WASHINGTON – The Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) has launched the Denis K. Anson Innovation Award, a $500 cash prize that will be presented to the “Audience Favorite” winner of the 2026 Developer’s Showcase at the Abilities International Accessibility Conference, March 26-27 in Los Angeles. The award is named in honor of RESNA Fellow and tech guru Denis Anson, who passed away last November after a four-year battle with cancer. “For years, Denis was known as the Tech Lab Guy at the RESNA Conference, and always participated in the Developers Showcase,” said Andrea Van Hook, executive director of RESNA. "He believed in sharing knowledge, fostering curiosity, and supporting the people who turn technology into meaningful impact. This award is a fitting tribute to the practical, clinician-centered creativity he championed throughout his career.” The Developers Showcase provides a platform for professionals, students, inventors and entrepreneurs to present innovative assistive technology (AT) products in various stages of the design phase and receive feedback from AT professionals and consumers. This event features new products, products under development and products currently being enhanced or redesigned that have the potential to improve the lives of individuals with disabilities. The Denis K. Anson Innovation Award winner will be selected by popular vote and announced at the conclusion of the Developers Showcase on March 27.