Explore

CMS Introduces MAHA ELEVATE Model to Expand Medicare Coverage for Lifestyle Medicine

CMS Introduces MAHA ELEVATE Model to Expand Medicare Coverage for Lifestyle Medicine

The Centers for Medicare & Medicaid Services (CMS) has announced a new payment model under the Trump administration, aimed at extending Medicare coverage to functional or lifestyle medicine providers. This initiative, known as the Make America Healthy Again: Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence (MAHA ELEVATE) model, will allocate $100 million to support up to 30 proposals over three-year agreements. The model is designed to offer additional healthcare options to Medicare beneficiaries, focusing on preventive care without replacing existing medical services. Abe Sutton, director of the Center for Medicare and Medicaid Innovation, emphasized that the goal is to empower Medicare recipients to lead healthier lives by addressing factors such as nutrition, physical activity, sleep, and stress. The CMS plans to launch the initial notice of funding opportunity in early 2026, with a full launch set for September.

CMS Launches MAHA Medicare Payment Model to Enhance Chronic Care and Nutrition

CMS Launches MAHA Medicare Payment Model to Enhance Chronic Care and Nutrition

The Centers for Medicare & Medicaid Services (CMS) has introduced a new initiative under the Medicare program called the MAHA (Medicare Advantage Health and Accountability) payment model. This initiative aims to improve chronic care and nutrition by allocating $100 million to up to 30 organizations. These funds are intended to support prevention and wellness programs, focusing on enhancing the quality of care for Medicare beneficiaries. The MAHA model is designed to address the growing need for comprehensive care strategies that incorporate nutrition and chronic disease management, reflecting a shift towards more holistic healthcare approaches.

CHI Health St. Francis Achieves Top Recognition from Forbes, Only Nebraska Hospital Honored

CHI Health St. Francis Achieves Top Recognition from Forbes, Only Nebraska Hospital Honored

CHI Health St. Francis has been recognized as one of the nation's top hospitals, earning a prestigious 5-star rating and inclusion in the inaugural 'Forbes Top Hospitals 2026' list. This distinction places St. Francis in the top 10% of hospitals nationwide for quality, safety, and value. The Forbes list, developed by a panel of experts, uses data from sources like the Centers for Medicare & Medicaid Services to evaluate hospitals based on patient outcomes, including mortality, readmission, and infection rates. St. Francis is the only hospital in Nebraska to receive this honor, highlighting its commitment to excellence in healthcare. The hospital has also received several other accolades this year, including a CMS 5-star Quality Rating and an 'A' Hospital Safety Grade from LeapFrog.

CLEAR Partners with CMS to Enhance Identity Verification in Medicare

CLEAR Partners with CMS to Enhance Identity Verification in Medicare

CLEAR, a company known for its identity verification technology, has announced a new contract with the Centers for Medicare & Medicaid Services (CMS) as part of the CMS Health Tech Ecosystem Initiative. This partnership is a significant step in the CMS's 'Kill the Clipboard' initiative, aimed at modernizing Medicare by improving interoperability and reducing fraud. CLEAR's technology, which uses biometric data and document checks, will be implemented to verify identities across healthcare organizations. This initiative is expected to streamline processes for Medicare beneficiaries and providers, allowing them to create and recover accounts and access healthcare information more securely. The technology is set to roll out on Medicare.gov in early 2026 and is compliant with HIPAA and IAL2 standards, ensuring patient data protection.

CLEAR Partners with CMS to Enhance Identity Verification in Healthcare

CLEAR Partners with CMS to Enhance Identity Verification in Healthcare

CLEAR, a company known for its identity verification technology, has signed a contract with the Centers for Medicare & Medicaid Services (CMS) to improve identity verification in the U.S. healthcare system. This partnership is part of CMS's 'Kill the Clipboard' initiative, which aims to modernize Medicare by enhancing interoperability and reducing fraud. CLEAR's technology uses biometric data and document checks to verify identities, allowing patients and providers to confirm their identities with a simple selfie. The initiative is expected to streamline healthcare processes and improve security.

Federal Health Policy Shifts Under Trump Administration Impact Medicaid and Hospital Funding

Federal Health Policy Shifts Under Trump Administration Impact Medicaid and Hospital Funding

The Trump administration has initiated significant changes in healthcare policy, affecting Medicaid funding, ACA subsidies, and hospital finances. These changes are part of a broader shift in the federal government's approach to health technology. A recent roundtable at the Fierce Health Payer Summit discussed these developments, highlighting Medicaid cuts, coverage losses, and the preparation of hospitals for reduced government funding. The Centers for Medicare & Medicaid Services (CMS) is also introducing a new health tech ecosystem, while pharmacy benefit manager (PBM) reform remains under scrutiny.

FDA Launches Pilot Program for Digital Health Devices to Access Medicare Payment

FDA Launches Pilot Program for Digital Health Devices to Access Medicare Payment

The Food and Drug Administration (FDA) has introduced a new pilot program that allows digital health devices to access a Medicare payment option through the Centers for Medicare and Medicaid Services (CMS). This initiative, known as the Technology-Enabled Meaningful Patient Outcomes (TEMPO) for Digital Health Devices Pilot, aims to facilitate the collection of real-world data by waiving certain premarket authorization and investigational device requirements. The CMS program, called Advancing Chronic Care with Effective, Scalable Solutions (ACCESS), is designed to address barriers in care due to Medicare’s fee-for-service model. It will provide recurring payments to healthcare sites managing patients with qualifying conditions, contingent on achieving measurable health outcomes. The FDA plans to accept up to 10 U.S.-based manufacturers in each of four focus areas: early cardio-kidney-metabolic, cardio-kidney-metabolic, musculoskeletal, and behavioral health.

CMS Relief Funds Misallocated Following Change Healthcare Cyberattack

CMS Relief Funds Misallocated Following Change Healthcare Cyberattack

A University of Minnesota analysis has revealed that the Centers for Medicare & Medicaid Services (CMS) overpaid many hospitals while failing to provide adequate relief to others following the 2024 Change Healthcare cyberattack. The Change Healthcare/Optum Payment Disruption (CHOPD) program, which distributed $3.3 billion in accelerated payments, was intended to support providers whose revenue cycles were disrupted by the cyberattack. However, the study found that at least 312 hospitals with significant revenue disruptions did not receive any funds, while about a third of the hospitals that did receive payments were overcompensated by $1 million or more. The program's opt-in nature and lack of targeted relief for the most affected providers were highlighted as areas needing improvement.

Welldoc Partners with CLEAR to Enhance Health Data Integration for Chronic Care

Welldoc Partners with CLEAR to Enhance Health Data Integration for Chronic Care

Welldoc, a leader in AI-driven cardiometabolic care, has announced a strategic partnership with CLEAR, a secure identity company, to integrate CLEAR1 identity verification into the Welldoc App by the first quarter of 2026. This collaboration aims to streamline the process of authenticating and aggregating fragmented medical records from multiple sources, addressing a significant bottleneck in digital health. The integration is part of the CMS Health Tech Ecosystem initiative, which seeks to modernize the health system by ensuring patient data travels with the patient. By embedding CLEAR1, Welldoc aims to create a 'trusted identity layer' that allows for secure and seamless access to sensitive medical records, enhancing the app's ability to provide personalized coaching for managing chronic conditions like diabetes and obesity.

Fierce Healthcare Discusses Federal Health Policy Shifts Under Trump Administration

Fierce Healthcare Discusses Federal Health Policy Shifts Under Trump Administration

Fierce Healthcare recently hosted a roundtable discussion at the Fierce Health Payer Summit, focusing on significant changes in healthcare policy since President Trump took office. The discussion highlighted several key areas, including Medicaid funding cuts, changes to Affordable Care Act (ACA) subsidies, and the financial impact on hospitals. Additionally, the roundtable addressed the federal government's evolving approach to health technology, particularly through the Centers for Medicare & Medicaid Services (CMS) and its new health tech ecosystem. The conversation also touched on the ongoing scrutiny and potential reforms of Pharmacy Benefit Managers (PBMs), which have been a contentious issue in healthcare policy.

CMS Relief Funds Overpaid Most Hospitals, Missed Hundreds After Cyberattack

CMS Relief Funds Overpaid Most Hospitals, Missed Hundreds After Cyberattack

The Centers for Medicare & Medicaid Services (CMS) provided financial relief to hospitals affected by the 2024 Change Healthcare cyberattack through the Change Healthcare/Optum Payment Disruption (CHOPD) program. However, a University of Minnesota analysis revealed that the relief funds were disproportionately distributed. Many hospitals received more than their Medicare revenue losses, while hundreds of others, particularly those in rural areas or with critical access designations, did not receive any funds despite significant revenue disruptions. The CHOPD program, which offered $3.3 billion in accelerated payments, was intended to support providers whose revenue cycles were disrupted by the cyberattack. The study highlighted that the program's opt-in nature and lack of targeted relief led to these discrepancies.

CMS Overpayment in Change Healthcare Hack Relief Funds Affects Hospitals

CMS Overpayment in Change Healthcare Hack Relief Funds Affects Hospitals

A University of Minnesota analysis has revealed that the Centers for Medicare & Medicaid Services (CMS) overpaid many hospitals while missing others in its relief program following the 2024 Change Healthcare cyberattack. The Change Healthcare/Optum Payment Disruption (CHOPD) program, which distributed $3.3 billion in accelerated payments, was intended to support providers whose revenue cycles were disrupted by the cyberattack. However, the study found that a third of the hospitals received more than $1 million in excess of their Medicare revenue losses, while another third did not receive enough to cover their losses. The analysis identified 312 hospitals that did not receive any funds despite experiencing significant revenue disruptions. The findings, published in Health Affairs, suggest that the CMS relief program did not adequately target the highest-need recipients.