Medicare & Medicaid

Medicare is requesting information, including physician commentary, on primary care and MAHA.

The top news stories in medicine this week.

Physicians drive savings, but AI could reward the intermediaries controlling ACOs.

Clinics and physician practices accounted for almost 30% of health care Chapter 11 filings in the first half of 2026, the one subsector climbing while the rest trended flat or down, according to a new Gibbins Advisors report.

A pediatrician at the center of the country's largest cyclospora outbreak on why the official case counts are almost certainly too low, and what most labs aren't looking for.

2027 Medicare Physician Fee Schedule at heart of Primary Care Collaborative discussion

Gary Jacobs argues the payment system is what makes small practices unsustainable, and that the physicians who wait it out usually end up selling to a hospital rather than choosing their own exit.

The OIG's own data suggest a narrower fix than the one CMS proposed

Medicare rates, prior authorization, telehealth and Medicaid coverage all change between Sept. 14, 2026, and Jan. 1, 2028.

Another conversion factor cut is on the table for 2027, and MGMA's Anders Gilberg breaks down why budget neutrality keeps forcing cuts in one specialty to pay for another and what the end of MIPS means for physicians.

The top news stories in medicine this week.

Health care economist Wayne Winegarden, Ph.D., argues that two decades of inflation-eroded Medicare payment, not corporate ownership or management services organizations, is what is pushing independent practices to sell.

Ambulatory Surgery Center Association analyzes financial effects in a growing part of U.S. health care.

Health care fraud, new payment models and AI are all in play in evolution of accountable care

RFK Jr. says California and Minnesota have to prove the legitimacy of claims before the money flows.

Health care economist Wayne Winegarden, Ph.D., makes the case that fixing Medicare payment, not restricting MSOs, is the way to keep independent practices open.

A new KFF Health Tracking Poll finds most voters believe Medicare and Medicaid fraud comes from the billing side of care, doctors’ offices and hospital systems, rather than from the patients who receive it.

Access, AI and accountable care are part of now and the future, CMS leaders say.

Health policy veteran and "Zen Lobbyist" author Gary Jacobs argues that the payment system, not the insurers, is behind a second straight year of double-digit ACA premium increases, and that primary care-led risk is the only durable fix.

The top news stories in medicine this week.

Actions this week involve three major health care policy bills

Greater availability of the blockbuster drugs does not mean every older patient should get them.

The draft 2027 Medicare Physician Fee Schedule opens five questions about the AMA's control of CPT codes, from licensing costs to who decides what a code is worth.

Physician lawmakers support primary care, inflation-indexed payments and new POINTS system for quality reporting.

CMS wants to cut the conversion factor, rewrite the G2211 add-on into a percentage modifier, halve payment for same-day procedures and put an expiration date on traditional MIPS.