The Centers for Medicare & Medicaid Services has barred MMM Healthcare, LLC, a San Juan, Puerto Rico, Medicare Advantage insurer, from enrolling new members in the plans under its Medicare Advantage-Prescription Drug contract H7522 for 2027. In a September 3 notice, CMS said every plan under that contract will be removed from the list of…

The federal government relies on outside contractors, not just state employees, to inspect a growing share of the nation’s roughly 15,000 nursing homes, and a new federal audit found that nobody is checking whether those contractors actually meet the government’s own standards. The finding matters to any family with a parent in a nursing home,…

Valley Health System, the largest hospital network serving the northern Shenandoah Valley out of Winchester, Virginia, is going out of network for UnitedHealthcare Medicare Advantage members on October 1, 2026. The break comes after UnitedHealthcare rejected Valley Health’s proposal to renew their contract, and it lands roughly two weeks before the Medicare Annual Enrollment Period…

Medicare will pay skilled nursing facilities 2.4 percent more starting October 1, 2026, the first day of the federal government’s 2027 fiscal year, under a final rule the Centers for Medicare & Medicaid Services published this summer. The increase is not a proposal still open for debate — CMS has already finalized it — and…

Medicare has been paying laboratories roughly 16 percent more than private insurers pay for the same clinical tests, according to the agency’s own comparison of its payment data against private-sector rates. The Centers for Medicare & Medicaid Services released that finding on September 21, 2026, alongside preliminary 2027 lab payment rates designed to close most…

The Centers for Medicare & Medicaid Services has confirmed it will shut down the Part D Premium Stabilization Demonstration at the end of this year, ending a two-year-old arrangement that used extra federal subsidy payments to keep standalone prescription drug plan premiums from spiking after the Inflation Reduction Act redesigned the Part D benefit. The…

The Centers for Medicare & Medicaid Services is adding four new disease-management tracks to a program that already reaches three out of four people on Medicare, with heart failure, chronic obstructive pulmonary disease, substance use disorders and tobacco cessation joining the lineup starting in spring 2027. The expansion arrives with a restriction the agency states…

Medicare Advantage enrollees who need a wheelchair, a glucose monitor or a hospital bed rarely think about who vetted the company that ships it. A new federal review says that gap in attention carries a real cost: the durable medical equipment suppliers facing the least screening are the same ones billing Medicare Advantage plans from…

A hospital network and an insurer that cover a large share of New York’s Medicare Advantage members are still working out the terms of a new contract, and the clock they set for themselves is running out. Neither side has announced a finished agreement, and neither has announced a breakup. For enrollees who rely on…

A regional hospital system in Southwest Florida is walking away from one of the nation’s largest health insurers, and the fallout lands on patients’ calendars rather than in a courtroom. Lee Health’s hospitals and physicians will stop taking UnitedHealthcare’s employer, individual and Medicare Advantage plans once the year turns over, leaving households across Fort Myers,…