Medicare

• The Centers for Medicare and Medicaid Services (CMS) inadvertently exposed Social Security numbers of thousands of doctors through a data breach. • The agency failed to adequately secure sensitive personal information in its systems, raising concerns about federal data protection practices. • The breach has prompted investigations into CMS security protocols and potential regulatory reforms.

• Medicare underpayments to hospitals totaled more than $100 billion in 2024, according to testimony provided to the House Ways and Means Committee by the American Hospital Association. • Hospitals are managing significant cost pressures while treating a sicker, more medically complex, and aging patient population, with persistent misalignments between care provision and reimbursement rates. • The financial strain reflects broader healthcare system challenges as providers struggle with inadequate government reimbursement alongside rising operational costs.

• The Medicare Payment Advisory Commission released its March 2026 Report to Congress, recommending a 0.5% increase in physician payments above current levels. • This proposal aims to address payment updates for Medicare services amid ongoing discussions on healthcare financing sustainability. • The report influences federal policy decisions on Medicare reimbursement rates for physicians across the US.

• The House Energy and Commerce Subcommittee held a March 17 hearing on CMS fraud prevention, with Deputy Administrator Kimberly Brandt detailing data analytics and real-time monitoring shifts. • Republicans highlighted improper payments in hospice, home health and Medicaid, calling for stronger oversight; Democrats urged balancing enforcement with patient access. • Lawmakers addressed fraud risks in durable medical equipment amid calls to end 'pay-and-chase' models.

• The Centers for Medicare & Medicaid Services announced expanded coverage for advanced lipid panels and inflammatory biomarker testing starting April 1, 2026, for beneficiaries age 50 and older. • The expansion removes prior authorization requirements for up to two tests annually, reflecting new evidence that early cardiovascular risk detection improves outcomes and reduces emergency hospitalizations by 18%. • CMS estimates the policy will affect approximately 28 million Medicare beneficiaries and cost $120 million annually while potentially preventing 8,000 heart attacks and strokes per year.