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November 12, 2026

Takeaways from the most recent news in the technology and policies shaping healthcare.

Government

CMS Seeks New Power to Remove 'Problematic' Medicare Providers

CMS is proposing to expand its own enforcement muscle. In the CY 2027 Home Health Prospective Payment System proposed rule, issued July 1, the agency asks for new authority to remove "problematic" and noncompliant providers from Medicare and to recoup their payments, according to Becker's Hospital Review. The power would apply across the entire Medicare program, not just home health.

The rule pairs that enforcement push with money. CMS proposes raising Medicare home health payments by 2.4% in 2027, a roughly $420 million increase. The combination is notable: higher reimbursement alongside a stronger ability to cut off agencies that violate program rules.

In practice, home health agencies and other Medicare providers should expect tighter compliance scrutiny and faster consequences for violations. The removal and recoupment authority signals CMS wants quicker tools to act on fraud, abuse, and noncompliance rather than relying solely on existing, slower processes. Providers should track the final rule closely, since the new powers could reshape how quickly agencies lose Medicare eligibility.

More in Government

Government

Democrats Float 'Medicare for Kids' Ahead of 2026 Midterms

Democrats are floating a narrower "Medicare for Kids" proposal alongside the broader Medicare for All push as healthcare shapes the 2026 midterm debate.

Why it matters: The direction of Democratic healthcare policy could reshape coverage, reimbursement, and payer dynamics across the industry depending on 2026 election outcomes.

Government

BIO Sues to Block Medicare Peer-Country Drug Pricing Pilot

BIO has sued to block a Medicare pilot that ties certain US drug prices to peer-country benchmarks, the latest challenge to Trump's most-favored-nation pricing push.

Why it matters: The outcome will shape how far the federal government can use Medicare pilots to push US drug prices toward what other countries pay.

Government

CMS Finalizes 2.4% Home Health Pay Bump for 2027

CMS finalized a 2.4% home health payment increase for 2027 while tightening Medicare provider enrollment rules to fight fraud.

Why it matters: The rule sets 2027 reimbursement for home health agencies and raises compliance stakes as CMS cracks down on fraud.