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4+ hour, 32+ min ago (402+ words) Several changes in the 2026 Medicare Physicians Fee Schedule, or PFS, will help to better support primary, preventive and comprehensive health care, according to several organizations. For example, the PFS introduces an efficiency adjustment that ACP said "will help account for how clinical practices and resource utilization patterns evolve and better align payments with those changes." While the AMA said it is pleased with certain changes, it also cautioned that some rules "may have unintended consequences for patients and private physician practices across the country." Specifically, CMS reduced physician payment rates for services delivered in hospitals and ambulatory surgical centers. "Because these cuts fail to reflect true resource costs incurred by physician practices in the facility setting, they risk reducing competition and encouraging consolidation," an AMA press release said. "Together, as proposed, these policies were estimated to result in 37% of oncologists…...

5+ hour, 41+ min ago (396+ words) With consumer prices continuing to rise, many older adults are searching for simple ways to save on everyday essentials. Yet an estimated $5 billion in over-the-counter (OTC) allowances available to Medicare Advantage members go unused each year - roughly 70% percent of benefits left on the table, according to the Consumer Healthcare Products Association. - Daily Update A roundup of the latest news, delivered weekdays. - Weekly Roundup Your source for Arkansas dining, culture and entertainment news, delivered Fridays. - Events Be first to know about upcoming events and local promotions, delivered occasionally. - Arkansas Times Climate Watch Climate change news for Arkansans from our agriculture and environment reporter, delivered twice monthly. With consumer prices continuing to rise, many older adults are searching for simple ways to save on everyday essentials. Yet an estimated $5 billion in over-the-counter (OTC) allowances available to Medicare Advantage members go unused each…...

7+ hour, 17+ min ago (600+ words) In less than a month, barring some kind of congressional intervention that probably isn't going to happen at this point, the ACA subsidies are going to end and monthly premiums are going to skyrocket for the 90 percent of ACA enrollees who are relying on them. Americans aren't too happy about that " even during the shutdown, over 70 percent of us still wanted to see them extended, including half of Republicans (also " 72 percent of "non-MAGA" Republicans). This may be part of why recent polling has shown that a large majority of Americans are once again in favor of Medicare for All. It's true! A survey from Data For Progress published late last month found that 65 percent of us either strongly or somewhat support "creating a national health insurance program, sometimes called "Medicare for All," including 49 percent of Republicans. Now, you may be…...

9+ hour, 54+ min ago (187+ words) New insights show that while investments in digital consumer experience (CX) are rising, agentic AI offers a scalable way to connect engagement to enterprise value. The report, based on a survey of 100 healthcare leaders from predominantly large US-based payer organizations, highlights that while health plans recognize CX as a top strategic priority, the value realization from growing digital and AI investments remains limited. The challenge shifts from one of intent to one of impact. Key Findings on Investment vs. Impact: "For 2026, the focus must shift to driving enterprise-wide value through connected digital and AI strategies," commented Greg Gilbert, Managing Director, Accenture. "Agentic AI is proving to be the catalyst that breaks through data silos, enabling smarter, continuous engagement needed to truly close care gaps, reduce spend, and significantly improve satisfaction." Unlocking Value: The 2026 Benchmark for High-Impact Healthcare'explores how leading health plans…...

11+ hour, 19+ min ago (1089+ words) Original Medicare doesn't cover everything, so plan ahead of time to pay for certain key services out of pocket. Taking advantage of Medicare is one of the best ways to stretch your retirement dollars further. The government-funded insurance program helps you pay for prescription medication, routine doctor's visits, and short-term hospital stays." However, there are some crucial things Medicare doesn't cover, including several common senior-specific medical issues that you might have assumed Medicare pays for. Keep reading to learn more about the medical expenses Medicare doesn't cover and how you can still access crucial services that aren't covered. Learn the strategies wealthy retirees use to fund their retirement with $1,000,000 " and how you can, too " with this new guide: The Definitive Guide to Retirement Income from Fisher Investments. Fisher Investments has helped tens of thousands of investors retire comfortably since 1979. With…...

12+ hour, 19+ min ago (906+ words) How rising 2026 Medicare costs can shrink your Social Security raise. Many retirees count on their yearly Social Security raise to help them retire comfortably and deal with rising prices. For 2026, that increase is set at 2.8%. But a big part of that bump may disappear before it ever reaches your bank account, thanks to higher Medicare premiums. This article walks through the new premiums, explains why they're rising, and shows how even a larger COLA can be offset by higher Medicare deductions. Learn the strategies wealthy retirees use to fund their retirement with $1,000,000 " and how you can, too " with this new guide: The Definitive Guide to Retirement Income from Fisher Investments. Fisher Investments has helped tens of thousands of investors retire comfortably since 1979. With over $332 billion under management, they provide tailored money management to help achieve long-term goals. Get your guide…...

20+ hour, 32+ min ago (767+ words) Every senior on Medicare should be intimately familiar with IRMAA " the initials that stand for Income Related Monthly Adjustment Amount. It's the amount by which your Medicare Part B and Part D premiums increase each year, based on your recent modified adjusted gross income (MAGI). The more you earn while on Medicare, the higher your monthly premiums for the insurance will be! It's not just earnings from work that are counted in the IRMAA formula. If you take your required minimum distributions from retirement accounts, it will boost your income " perhaps into the IRMAA adjustment phase. Or if you convert a traditional IRA to a Roth, it could impact you in the formula, raising your Medicare premiums. And those premiums really jump when you have more income. The standard Medicare Part B premium for 2026 is $202.90 per month, a $17.90 increase from…...

1+ day, 2+ hour ago (951+ words) In a groundbreaking study that promises to reshape neonatal care protocols, researchers have delved into the tangible effects of the American Academy of Pediatrics" (AAP) 2022 revised clinical practice guidelines for managing neonatal hyperbilirubinemia. This highly specialized area of newborn care, marked by the accumulation of bilirubin leading to jaundice, has long demanded precise intervention [] In a groundbreaking study that promises to reshape neonatal care protocols, researchers have delved into the tangible effects of the American Academy of Pediatrics" (AAP) 2022 revised clinical practice guidelines for managing neonatal hyperbilirubinemia. This highly specialized area of newborn care, marked by the accumulation of bilirubin leading to jaundice, has long demanded precise intervention to prevent dangerous complications such as kernicterus. The recent revisions aimed to refine existing strategies, but until now, the real-world impact of these updated guidelines on healthcare outcomes remained elusive. This pioneering…...

1+ day, 2+ hour ago (818+ words) The U.S. Department of Health and Human Services Office of Inspector General (OIG) Provider Self-Disclosure Protocol (SDP) provides a well-established and important avenue for all health care entities subject to OIG's CMP authorities to proactively address and resolve fraud and abuse concerns. Utilizing the SDP can help mitigate potential penalties, promote transparency, and demonstrate an organization's strong commitment to compliance and ethical conduct....By: Baker Donelson Proactive Compliance: When Should an Internal Finding Become an OIG Self-Disclosure? The U.S. Department of Health and Human Services Office of Inspector General (OIG) Provider Self-Disclosure Protocol (SDP) provides a well-established and important avenue for all health care entities subject to OIG's CMP authorities to proactively address and resolve fraud and abuse concerns. Utilizing the SDP can help mitigate potential penalties, promote transparency, and demonstrate an organization's strong commitment to compliance and ethical conduct. The OIG…...

1+ day, 4+ hour ago (192+ words) CMS releases MA and Part D proposed rule. The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule with policy and technical changes to the MA and Part D programs for 2027 and beyond. Key takeaways include: Comments on the proposed rule are due by January 26, 2026. Read CMS's fact sheet on the proposed rule here. You can also read our Regs & Eggs blog post on this topic. The 15 Part D-covered drugs selected for 2027 will join the 10 Part D-covered drugs previously selected for negotiation, with those prices going into effect January 1, 2026. A fact sheet detailing the negotiated prices for the 15 selected drugs can be found here. The ACCESS model will test outcome-aligned payments for care organizations enrolled in Medicare Part B and will include four clinical tracks focused on common chronic conditions: FAQs on the ACCESS model can be found here....