Medicare Policy
Expert articles and analysis related to medicare policy.
AI Summary â Last 7 Days
CMS is accelerating mandatory Medicare payment model activity under the Trump administration: it expanded the Comprehensive Care for Joint Replacement model through CJR-X and released participant lists, while finalizing the mandatory GLOBE Part B drug pricing demonstrationânow narrowed in scope but already drawing PhRMA litigation over federal drug payment authority. For VBC stakeholders, the pattern is clear: CMS is pairing episode-based accountability in procedures like joint replacement with drug-spend controls, increasing pressure on hospitals, specialists, and life sciences partners to manage total cost exposure across service lines. At the same time, Medicare Advantage oversight is tightening through fraud settlements tied to risk adjustment and expected Star Ratings changes, reinforcing that MA revenue models will face more scrutiny around coding, quality performance, and compliance ([CJR-X participant list](https://news.google.com/rss/articles/CBMiwgFBVV95cUxQc3J0MW1vb3Y3Z05COGFjQlI3U0hRQ0lNZFM4bWxTR3dPUHpnWDEwNllNN1kxUlZuWVNabDEwOXFuTGcyR2pYeThBMnlZaVRvRGt5cmZ3WGx3czhLNXJid193cXdyWnh2N2RqZ3NrUmlQYm02dkxJbEVBZmc4ZkpFdHE0Y3Y3cVZYWTNTOG84ekx
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