Tag: Centers for Medicare & Medicaid Services (CMS)
CMS finalizes changes to dispute resolution process
June 1, 2026HME News Staff
WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) has published a final rule that it says makes the Federal Independent Dispute Resolution (IDR) process more efficient and transparent, while saving money for millions of Americans. Since launching in April 2022, CMA says the Federal IDR process has received more than 5 million disputes – far exceeding expectations and creating delays and unnecessary costs. The agency says the rule addresses those bottlenecks by reducing ineligible...
CMS will not take action on Elevance Health at this time
June 1, 2026HME News Staff
WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) has notified Elevance Health that it will not impose intermediate sanctions on the insurer at this time. The agency says it is satisfied that Elevance has:
Completed the initial submission in its established electronic systems (Risk Adjustment Processing System, the Encounter Data Processing System and the Risk Adjustment Overpayment Reporting module); and
Remitted a wire transfer of the total overpayment amount based on...
CMS proposes changes to state-directed provider payment rates
May 21, 2026HME News Staff
WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) has published a proposed rule that would cap state-directed provider payment rates at 100% of Medicare payment rates for expansion states and 110% of Medicare payment rates for non-expansion states (or 100% of the Medicaid state plan rate if a comparable Medicare rate is not available).
The rule would also:
Apply similar limits to certain targeted Medicaid fee-for-service payments, and
Establish consistent national standards...
In brief: New moratorium, new Medtrade owner, new stay-of-enrollment scope
May 15, 2026HME News Staff
WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) will implement a six-month, nationwide data-driven moratorium on new Medicare enrollment for hospices and home health agencies (HHAs).
CMS says the moratorium, which will temporarily halt the influx of new providers into these high-risk categories, continues the Trump Administration’s crackdown on fraud, waste and abuse in the Medicare program.
“We’ve seen systemic and deeply troubling fraud in the hospice...
CMS takes next step to improve prior authorizations
May 11, 2026HME News Staff
WASHINGTON – The Centers for Medicare & Medicaid Services has added electronic prior authorization to its Health Tech Ecosystem. The agency says health systems, hospitals, physician practices, electronic health record (EHR) vendors and digital health developers are now joining payers as a unified coalition aligned around improving electronic prior authorization.
Working groups have been formed, vendors work to streamline process
Committed working groups across these stakeholders will...
In brief: ACU-Serve’s executive boost, CMS’s next prior auth move, McKesson’s & Medline’s results
May 11, 2026HME News Staff
AKRON, Ohio – ACU-Serve has appointed Natasha Baria Mehta as president, a strategic leadership addition that the company says reflects its continued investment in growth, operational excellence and innovation across the health care revenue cycle management (RCM) industry.
In this role, Mehta will oversee operational strategy, organizational performance and long-term growth initiatives across ACU-Serve’s HME, infusion and home health divisions. She will focus on strengthening operational...
Stakeholders make case to CMS Administrator Oz on bid program, moratorium
May 1, 2026Theresa Flaherty, Managing Editor
WASHINGTON – Industry stakeholders left a recent meeting with Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz buoyed by his “willingness” to work with the home medical equipment (HME) industry on a host of concerns.
The 35-minute meeting, which also included Deputy Administrator Kim Brandt, was the first between AAHomecare leadership and Oz.
“We’ve been working hard to engage CMS and the Administration ever since the proposed rule came...
AAHomecare meets with high-level CMS officials
April 30, 2026HME News Staff
WASHINGTON – The leadership at AAHomecare – including providers Josh Marx and David Siegel – met with Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz and Deputy Administrator Kim Brandt recently to discuss strengthening the competitive bidding program and clarifying the moratorium on new supplier enrollments.
AAHomecare stated in a recent bulletin:
Officials have signaled concern for Medicare fraud, waste and abuse and expressed interest in leveraging...
CMS highlights new digital health tools
April 13, 2026HME News Staff
WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) has released a new Medicare App Library and an initial set of patient-facing applications as part of its HealthTech Ecosystem Live! First Wave Launch event. The agency introduced interoperable tools to streamline care and improve patient experience, including:
Digital data access and check‑in (“Kill the Clipboard”), allowing patients to securely share information with a simple scan on their phone.
Personalized...
Stakeholders push for targeted, measured fraud-fighting efforts
April 6, 2026HME News Staff
WASHINGTON – Industry stakeholders VGM Group and AAHomecare have submitted comments on a request for information (RFI) from the Centers for Medicare & Medicaid Services (CMS) on Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH).
VGM says its comments reflect its support of CMS’s goal of strengthening program integrity and its shared goal of protecting Medicare beneficiaries and taxpayer dollars from fraud, waste and abuse.
The organization’s recommendations...