CMS

Medicare Reform Analysis Update

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The real Medicare reimbursement reform analysis starts with a hard truth: this is no longer a debate about payment mechanics. It is a debate about who absorbs risk, which care settings remain financially viable, and whether federal policy can restrain spending without destabilizing access. For operators in post-acute care, senior living, home health, hospice, and … Read more

CMS: Moratorium on Hospices and Home Health

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On May 13, 2026, the Centers for Medicare & Medicaid Services (CMS) imposed a nationwide six-month moratorium on new Medicare enrollments for hospice providers and home health agencies (HHAs). The action follows a recent executive order creating a federal task force to prevent fraud and disrupt fraud networks. Scope of the Action The new restrictions … Read more

Presentation: Medicare is Bankrupting America

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A couple of weeks ago, I did a webinar for Freedom Hub titled Medicare is Bankrupting America. The links to view the program are below. A number of folks have messaged me asking for the Power Point (if I would oblige). The presentation is available here and feel free to download (no charge): Medicare Bankrupting … Read more

Program: Medicare is Bankrupting America

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Last week I had the chance to work with Freedom Hub on a program called Medicare is Bankrupting America. It was a great discussion/webinar covering lots of economic and health policy information. The program is now available to watch on Rumble or X. The Rumble link is here: https://rumble.com/v767s6y-medicare-is-bankrupting-america.html The X link is here: https://x.com/freedom_hub1/status/2026349274011685014/video/1 … Read more

Rural Health Transformation Program Overview

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On December 29, 2025, the Centers for Medicare & Medicaid Services (CMS) announced the inaugural state awards from the $50 billion Rural Health Transformation Program CMS Announces $50 Billion in Awards to Strengthen Rural Health in All 50 States | CMS. The program was created as a policy vehicle to mitigate the potential negative effects … Read more

Site Neutral Payments Kick-0ff!

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As of January 1, 2026, the scope of Medicare’s site-neutral payment policy expands to include drug administration services—such as chemotherapy and other infused therapies—furnished in excepted (grandfathered) off-campus provider-based departments (PBDs) of hospitals. Under the CY 2026 OPPS final rule published by CMS: CY 2026 OPPS and Ambulatory Surgical Center Final Rule – Hospital Price … Read more

Medicare Hospice TPE Basics and Update

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Within the last few weeks, I’ve had the opportunity to discuss and review, the ongoing Medicare TPE program with a number of hospices and hospice folks. Suffice to say, there are more than a few questions and resultant (still) confusion over the audit process and claims denial in general. I hope this post provides some … Read more

Hospital-at-Home Waiver Ended – What Next?

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Last week, I wrote a couple of posts regarding Medicaid, the Affordable Care Act/insurance premium subsidies and the government shutdown. The second of the two posts contained a quick summary of the shutdown impact on Hospital-at-Home programs. https://rhislop3.com/shutdown-is-over-the-pieces/ This post elaborates further on the Hospital-at-Home program, the end of the waiver, the end of the … Read more

CMS Releases Strategy on MAHA

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The Centers for Medicare & Medicaid Innovation (Innovation Center), formerly known as CMMI and part of the Centers for Medicare & Medicaid Services (CMS) under the US Department of Health & Human Services (HHS), has released a White Paper (CMS Innovation Center Strategy to Make America Healthy Again | CMS ) outlining a strategic direction … Read more