Morning Briefing
Summaries of health policy coverage from major news organizations
Medicare Finalizes Doctor Payment Rates And Outpatient Reimbursements For 2027
Modern Healthcare: CMS Cuts Medicare Physician Payments For 2027
Doctors will see reductions to their Medicare payments for 2027 under a final rule the Centers for Medicare and Medicaid Services issued Wednesday. The conversion factor used to calculate physician payment rates would drop 2.31% for most physicians and 1.83% for those who participate in an advanced alternative payment model. CMS also finalized an array of proposals that would restructure how providers are paid for their time and update certain codes, which the agency said in a news release would help cut down on duplicative payments. (Early, 11/4)
Modern Healthcare: CMS Finalizes 2.3% Medicare Hospital Outpatient Pay Bump For 2027
Hospital outpatient departments and ambulatory surgical centers are set for 2.3% Medicare reimbursement hikes next year under a final rule issued Wednesday. The Centers for Medicare and Medicaid Services also finalized modified versions of two controversial policies that would reduce rates for medications purchased under the 340B Drug Pricing Program and speed a complicated financial recoupment and redistribution process to rectify prior 340B cuts that were undone in court. (Early, 11/4)
Modern Healthcare: CMS Rule Widens Medicare Powers, Boosts Home Health Pay For 2027
The Centers for Medicare and Medicaid Services published a final rule Wednesday expanding its ability to exclude providers from Medicare. The agency has cited the policy as an anti-fraud tool, but critics have said it will harm good actors in the program. “These changes will help protect seniors, safeguard taxpayer dollars and preserve access to the care beneficiaries need,” CMS Administrator Dr. Mehmet Oz said in a news release. (Early, 11/4)
Other news from the Trump administration —
The New York Times: Trump Administration Moves To Oust Arbitrators As Doctor Payouts Soar
The federal government plans to end contracts with two arbitration firms that settle medical billing disputes under the No Surprises Act, a consumer protection law that has come under scrutiny for high payouts for doctors. Congress passed the law in 2020 to protect patients from surprise bills when they saw a doctor who did not have a contract with their health plan, such as in emergencies. The law, which took effect in 2022, calls for health care providers and insurers to settle on a price and when they cannot, for arbitrators to review an offer from each side, and pick one. (Sanger-Katz and Kliff, 11/4)
KFF Health News: Trump Administration Delays Awards Slated To Improve Rural America’s Health
Federal leaders overseeing a $50 billion rural health fund missed a critical deadline to announce how much they’ll give states next year, alerting state leaders to the delay with a mass email. A 12-sentence message from Alina Czekai, director of the federal Office of Rural Health Transformation, said officials “discovered an additional administrative process requirement.” The Rural Health Transformation Program, which President Donald Trump touted as an “unprecedented” investment to “revitalize hospitals in our cherished rural communities,” calls for federal regulators to award states shares of $10 billion a year for five years. (Tribble, Zionts, and Sable-Smith, 11/5)
Modern Healthcare: The Medicaid Work Requirements Court Ruling, Explained
A court ruling relaxing a key aspect of Medicaid work requirements could alleviate pressure on states and providers, but critical questions about federal enforcement remain. Last Thursday, U.S. District Court for the District of Massachusetts decided that the Centers for Medicare and Medicaid Services impermissibly narrowed the “medical frailty” exemption from work requirements. (Early, 11/4)
An update about Joe Biden's cancer fight —
The Times: Joe Biden’s Cancer ‘Incredibly Taxing On The Body,’ Says Son Hunter
Joe Biden’s cancer treatment is “incredibly taxing on the body”, his son has said after the former president’s disease spread to his bones. The 83-year-old was diagnosed with aggressive prostate cancer in May 2025, four months after he left office after a single term in the White House. Biden’s son Hunter told Times Radio: “It is hard. Stage-four metastatic bone cancer can be treated by hormone therapy, and it is. Right now, everything looks good but it is also painful and it’s also incredibly taxing on the body. “I complain more about it than he does, though. He was just out here. I’m in California and he came out and spent the last week with me. He’s doing great. I just worry about him all the time.” (Kendix, 11/2)
