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AHA releases Q2 2025 Health Care Plan Accountability Update
The AHA July 3 released the Health Care Plan Accountability Update for the second quarter of 2025.
DOJ, HHS announce working group to investigate health care fraud
The Departments of Justice and Health and Human Services today announced the cr
CMS warns of phishing fax scheme; AHA monitoring other reported social engineering schemes
The Centers for Medicare & Medicaid Services today announced it has identified a fraud scheme targeting Medicare providers and suppliers.
NORC, Coalition report finds MA patients face longer hospital stays, reduced follow-up care access
A report released June 17 by NORC at the University of Chicago, commissioned by the Coalition to Strengthen America’s Healthcare, found that patients enrolled in Medicare Advantage plans are more likely to experience longer hospital stays and experience delays in transfer to post-acute care facilities than those on Traditional Medicare.
CMS to expand audits of MA plans
The Centers for Medicare & Medicaid Services May 21 announced it will immediately begin annual audits of all Medicare Advantage plans and work to clear a backlog of audits from 2018 through 2024.
CMS requests comments on MA service level data collection for initial determinations, appeals
The Centers for Medicare and Medicaid Services May 30 released a
AHA comments to CMS on FY 2026 IPPS proposal
The AHA commented (https://www.aha.org/system/files/media/file/2025/06/aha-comments-on-cms-fy-2026-inpatient-prospective-payment-system-proposed-rule-letter-6-10-2025.pdf) to the Centers for Medicare & Medicaid Services June 10 on the fiscal year 2026 inpatient prospective payment system proposed rule (https://www.aha.org/news/headline/2025-04-11-cms-issues-hospital-ipps-proposed-rule-fy-2026), expressing support for several provisions, including a proposed increase in disproportionate share hospital payments and several aspects of the agency’s quality-related proposals.
Reduced FY 2026 LTCH payment updates ‘inadequate,’ AHA tells CMS
The AHA expressed concerns to the Centers for Medicare & Medicaid Services today on payment updates for the fiscal year 2026 proposed rule for the long-term care hospital prospective payment system (https://www.aha.org/news/headline/2025-04-11-cms-releases-fy-2026-proposed-rule-long-term-care-hospitals). The updates include an insufficient market basket update and reduced overall payments to LTCHs due to an increase in the high-cost outlier fixed-loss amount.
AHA provides comments on TEAM proposed rule, asks CMS to make voluntary
The AHA commented on proposed changes to the Transforming Episode Accountability Model, a new, mandatory, episode-based payment model scheduled to begin Jan. 1, 2026.
AHA comments on IPF proposed rule for FY 2026
The AHA June 10 commented (https://www.aha.org/system/files/media/file/2025/06/aha-comments-on-cms-inpatient-psychiatric-facility-fy-2026-proposed-payment-rule-letter-6-10-2025.pdf) on the fiscal year 2026 inpatient psychiatric facility proposed rule (https://www.aha.org/news/headline/2025-04-11-inpatient-psychiatric-facilities-rule-would-increase-payments-24), expressing support for several provisions such as increases in the facility-level adjustments.