News
CMS Addresses Agent And Broker Marketing Reforms In ACA Marketplaces
12+ min ago (198+ words) In a proposed rule for the 2027 Notice of Benefit and Payment Parameters, published on February 11, 2026, the Centers for Medicare & Medicaid Services (CMS) proposed various reforms for the Affordable Care Act (ACA) market. One aim of the reforms is to curtail…...
Four Takeaways From The Business Of Healthcare Conference At The University of Miami Herbert Business School
19+ min ago (408+ words) Four themes stood out. Each reflects a healthcare system under pressure to modernize, constrained not only by legacy infrastructure, but by the practical realities of incentives and the "who pays" question that often sits underneath reform conversations. 1) Augmented Intelligence in…...
Bill to Limit Classification of Insurers as ‘Systemically Important’ Receives Bipartisan Approval by the House
1+ hour, 5+ min ago (499+ words) On February 9, 2026, the House of Representatives, in a bipartisan vote, approved H.R. 3682. This bill would place additional guardrails on the Financial Stability Oversight Council (FSOC) in designating insurance companies as systemically important financial institutions (SIFI). The FSOC was established in the…...
The Ghost in the Machine (Readable Files): Proposed Transparency in Coverage Amendments Attempt to Shed Additional Light on Health Plan Data
1+ hour, 42+ min ago (751+ words) For MRFs,[3] the Departments focuses on: Reporting of Product type" " New " The Departments also propose to add a requirement for plans and issuers to report the product type (e.g., Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO)) associated with the…...
CAA 2026: NPI and Attestation Requirements for Off-Campus Provider-Based Departments to Avoid Losing Medicare Reimbursement
3+ hour, 45+ min ago (153+ words) Section 6225 of the Consolidated Appropriations Act of 2026 (CAA 2026), enacted on February 3, 2026, fundamentally changes Medicare's treatment of hospital off-campus provider-based departments. CAA 2026 eliminates that discretion. Attestations will no longer be optional compliance tools; they become statutory prerequisites to Medicare payment. Likewise,…...
Client Alert: Change of Ownership in Health Care
1+ day, 2+ hour ago (566+ words) For health care leaders and compliance officers, understanding the regulatory and contractual implications of a "Change of Ownership" (CHOW) is critical to maintaining operational continuity and regulatory compliance. The definition of a CHOW varies depending on the applicable license, permit,…...
Florida’s Healthcare System and the Impacts from the One Big Beautiful Bill and Legislation
1+ day, 3+ hour ago (203+ words) For retailers and pharmacies accepting SNAP, stricter error controls and penalties for trafficking or improper acceptance can lead to disqualification and civil money penalties. Robust tender controls, employee training, and incident response protocols are essential to avoid violations. Monetizable reputational…...
CMS Updates Pay, Price Rules and Adds New Quality Steps for 2026
2+ day, 3+ hour ago (687+ words) The Centers for Medicare & Medicaid Services (CMS) are required to update and publish payment policies and rates for hospital outpatient departments and ambulatory surgery centers (ASCs) annually." In November 2025, CMS released their "final rule" which details changes to payment policies…...
CMS Releases Updated Guidance on State Directed Payment Programs Affected by Section 71116 of the Working Families Tax Cuts Legislation
2+ day, 7+ hour ago (218+ words) On February 2, 2026, CMS issued updated guidance on Medicaid state directed payment (SDPs) governed by Section 71116 of the Working Families Tax Cuts Legislation enacted in the One Big Beautiful Bill Act (OBBBA). The update replaces September 2025 guidance and reaffirms that SDPs…...
Texas Regulatory Action Underscores Insurer Accountability for TPA Compliance
2+ day, 17+ hour ago (391+ words) Key Takeaways: A Florida-based insurer was recently fined by the Texas Department of Insurance for failing to ensure the competent administration of its programs by working with an unlicensed TPA and failing to conduct statutorily required semiannual reviews and biennial…...