CMS Encourages Providers to Prepare for e-Prior Authorization
Starting January 1, 2027, certain health plans regulated by the Centers for Medicare and Medicaid Services (CMS) must implement and maintain Application Programming Interfaces (APIs) to support electronic prior authorization.
New Bill Replaces Merit-Based Incentive Payment System
Reps. Mariannette Miller-Meeks, MD (R-IA) and Herb Conaway, MD (D-NJ) have introduced the Medicare Physician Data-driven Performance Payment System Act of 2026.
Insurers Make Prior Authorization Data Available to Public
A new federal transparency requirement is making health plan prior authorization data publicly available for the first time—including for many Medicare Advantage (MA), Medicaid managed care, CHIP, and Affordable Care Act Marketplace plans.
Are You Required to Participate in Medicare’s New Payment Model? Check the CMS List to Find Out
As previously reported by ACOI, the Centers for Medicare and Medicaid Services (CMS) will launch two new payment models for heart failure and lower back pain on January 1, 2027.
Beginning July 1, 2026 through Dec. 31, 2027, Medicare beneficiaries with Part D coverage may be eligible to access certain GLP-1 medications for $50 per month.
U.S. Citizenship and Immigration Services (USCIS) has lifted processing holds on immigration benefit applications filed by or on behalf of medical physicians.
