CMS raises Medicare Advantage rates for 2027; Trinity Hospital to pay $1.7M over Stark Law violations; Novo Nordisk launches higher-dose Wegovy HD – Morning Medical Update

CMS raises Medicare Advantage payments 2.48%

The increase, higher than a near-flat January proposal, translates to more than $13 billion in additional payments to plans in 2027.

The Centers for Medicare & Medicaid Services (CMS) will raise payments to Medicare Advantage (MA) insurers by an average of 2.48% in 2027, a significant jump from the 0.09% increase proposed in January, with an additional 2.5% adjustment tied to risk assessment changes bringing the total effective increase to roughly 5%. CMS said the final rate will result in more than $13 billion in additional payments to MA plans. Reuters reported that shares of UnitedHealth, Humana and CVS rose between 8% and 14% in extended trading following the announcement.

Trinity Hospital agrees to pay $1.7M to resolve Stark Law violations

The Ohio hospital self-disclosed improper office space rental arrangements with two referring physicians after an internal investigation.

Trinity Hospital in Steubenville, Ohio, has agreed to pay the United States $1.7 million to resolve allegations that it violated the Physician Self-Referral Law — commonly known as the Stark Law — by entering into above-market office space rental arrangements with two referring physicians between 2014 and 2020. The Stark Law prohibits hospitals from billing for services referred by physicians with whom they have a financial relationship unless specific exceptions apply. Trinity self-reported the arrangements to the government following an internal compliance review and independent investigation, and prosecutors credited the hospital for its cooperation and remedial steps in reaching the settlement.

Novo Nordisk launches higher-dose Wegovy in the United States

The 7.2 mg injectable dose, approved last month, is three times the previous maximum authorized dose for weight loss.

Novo Nordisk has made a higher-dose version of Wegovy available across the United States, nearly three times the previous maximum authorized dose of 2.4 mg. The 7.2 mg injectable, branded Wegovy HD, received Food and Drug Administration (FDA) approval in March under the Commissioner’s National Priority Review Voucher program and is now available through U.S. pharmacies, NovoCare Pharmacy and select telehealth providers. Patients paying cash can expect to pay $399 per month for Wegovy HD. Commercially insured patients may pay as little as $25 per month through the company’s savings program. Reuters has more.